Healthcare Provider Details

I. General information

NPI: 1992637011
Provider Name (Legal Business Name): SAMANTHA SHIRL SAMARELLI LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 NW 84TH AVE STE 200
PLANTATION FL
33324-1807
US

IV. Provider business mailing address

2938 SW 22ND CIR APT 10C
DELRAY BEACH FL
33445-7905
US

V. Phone/Fax

Practice location:
  • Phone: 732-600-3017
  • Fax:
Mailing address:
  • Phone: 732-600-3017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH27822
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: