Healthcare Provider Details

I. General information

NPI: 1588571012
Provider Name (Legal Business Name): SAMANTHA AMABILE LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 DRUID RD E STE 512
CLEARWATER FL
33756-3942
US

IV. Provider business mailing address

5340 W KENNEDY BLVD UNIT 622
TAMPA FL
33609-2452
US

V. Phone/Fax

Practice location:
  • Phone: 800-457-4573
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH28190
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: