Active NPI
Samantha Poncere Daniels, MS
- Professional Counselor
- Evans, GA
National Provider Identifier
1992323430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC006854
- Practice address
- 4573 Cox Rd Ste B
Evans, GA 30809-3449 - Phone
- (706) 922-3027
- Fax
- (706) 364-8996
- NPI assigned
- Jul 10, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC006854 | GA | Primary |
Addresses
Primary practice location
4573 Cox Rd Ste B
Evans, GA 30809-3449
Mailing address
PO Box 5741
Augusta, GA 30916-5741
Phone (706) 373-8619
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC006854 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594339200000",
"number": "1992323430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5741",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309165741",
"telephone_number": "706-373-8619",
"fax_number": "706-922-3027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4573 COX RD STE B",
"city": "EVANS",
"state": "GA",
"postal_code": "308093449",
"telephone_number": "706-922-3027",
"fax_number": "706-364-8996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIELS",
"first_name": "SAMANTHA",
"middle_name": "PONCERE",
"name_prefix": "Ms.",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-10",
"last_updated": "2020-07-10",
"certification_date": "2020-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC006854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evans, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.