Active NPI
Samantha Mack
- Psychologist
- Anchorage, AK
National Provider Identifier
1972956274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 172962
- Practice address
- 4107 Laurel St
Anchorage, AK 99508-5334 - Phone
- (907) 302-4465
- Fax
- (907) 290-8525
- NPI assigned
- Jul 21, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 172962 | AK | Primary |
Addresses
Primary practice location
4107 Laurel St
Anchorage, AK 99508-5334
Mailing address
4107 Laurel St
Anchorage, AK 99508-5334
Phone (907) 302-4465
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 172962 | AK | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alaska Telepsychology | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- Anchorage, AK
- NPI 1184263741
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775260800000",
"number": "1972956274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4107 LAUREL ST",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995085334",
"telephone_number": "907-302-4465",
"fax_number": "907-290-8525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4107 LAUREL ST",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995085334",
"telephone_number": "907-302-4465",
"fax_number": "907-290-8525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACK",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-21",
"last_updated": "2026-04-04",
"certification_date": "2026-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AK",
"license": "172962",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.