MEDICARE: SAMSON TEKLEMARIAM LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	5606	SC
2	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3000641104	OTHER	SC	WORKER'S COMP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699907501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMSON TEKLEMARIAM LPC

Provider Business Mailing Address
First Line	:	210 EMERSON HEIGHTS DR
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30188-2522
Country	:	US
Telephone Number	:	678-551-0287
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 EMERSON HEIGHTS DR
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30188-2522
Country	:	US
Telephone Number	:	678-551-0287
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2009
Last Update Date	:	05/20/2024

Similar Medicare Providers

1942835517 — ERIN SMITH LMSW
Practice Location Address:

3235 S CHEROKEE LN BLDG 1200
WOODSTOCK, GA
30188-4461

Practice Phone: 319-640-6475
Practice Fax:

1629752084 — JULIA NAILOR LMSW
Practice Location Address:

3235 S CHEROKEE LN BLDG 1200
WOODSTOCK, GA
30188-4461

Practice Phone: 678-384-4911
Practice Fax:

1184559502 — 9P WOODSTOCK LLC
Practice Location Address:

11517 HIGHWAY 92 STE 110
WOODSTOCK, GA
30188-4310

Practice Phone: 678-667-7469
Practice Fax: 470-970-5961

1659206761 — JENNY LYNN COLLIER
Practice Location Address:

270 HERITAGE WALK
WOODSTOCK, GA
30188-3875

Practice Phone: 770-618-9820
Practice Fax:

1508792441 —
Practice Location Address:

11517 HIGHWAY 92 STE 110
WOODSTOCK, GA
30188-4310

Practice Phone: 678-667-7469
Practice Fax: 470-970-5961

1902730724 — LOGAN JACKSON
Practice Location Address:

3235 S CHEROKEE LN STE 1200
WOODSTOCK, GA
30188-4461

Practice Phone: 678-384-4911
Practice Fax:

Directions to “ SAMSON TEKLEMARIAM LPC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.