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NPI Code Detail

MEDICARE: MRS. SAMANTHA L. JIMENEZ LMFT

MEDICARE: MRS. SAMANTHA L. JIMENEZ LMFT
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
1106H00000XMarriage & Family Therapist1342OK
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1578990024
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SAMANTHA L. JIMENEZ LMFT
Provider Business Mailing Address
First Line : 2641 SW 107TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73170-2431
Country : US
Telephone Number : 405-551-1366
Fax Number :
Provider Business Practice Location Address
First Line : 2641 SW 49TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73119-5228
Country : US
Telephone Number : 405-551-1366
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2013
Last Update Date : 01/07/2026

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