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General NPI Number Information
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NPI Number | 1871492744
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Entity Type | Individual
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Provider Name | JEAMELAH SAMEDY
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Gender | Female
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Dates
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Enumeration Date | 11/05/2026
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 5755 SHATTALON DR
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City | WINSTON SALEM
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State | NC
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Zip | 27105-1332
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Country | US
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Telephone | 336-784-9470
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Fax |
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Provider Business Mailing Address
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Address Line | 3 YESTER OAKS CT APT D
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City | GREENSBORO
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State | NC
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Zip | 27455-3125
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Country | US
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Telephone | 929-206-7358
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | NC
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