MEDICARE: MS. PATRICIA GAIL SAMPSON M.S., CAPP

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor		FL
2	101YM0800X	Mental Health Counselor		FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851317374
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA GAIL SAMPSON M.S., CAPP

Provider Business Mailing Address
First Line	:	2392 EDGEWOOD AVE N
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32254-1725
Country	:	US
Telephone Number	:	904-781-7797
Fax Number	:	904-781-8729

Provider Business Practice Location Address
First Line	:	2392 EDGEWOOD AVE N
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32254-1725
Country	:	US
Telephone Number	:	904-781-7797
Fax Number	:	904-781-8729

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	09/11/2025

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