Healthcare Provider Details

I. General information

NPI: 1053128587
Provider Name (Legal Business Name): ROCHELLE LEE SAMPSON PRSS-5281
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2024
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E WINNEMUCCA BLVD
WINNEMUCCA NV
89445-2937
US

IV. Provider business mailing address

1200 E WINNEMUCCA BLVD
WINNEMUCCA NV
89445-2937
US

V. Phone/Fax

Practice location:
  • Phone: 775-623-1888
  • Fax:
Mailing address:
  • Phone: 775-623-1888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number08305-I
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberPRSS-5281
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: