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NPI Code Detail

MEDICARE: EMILY SAMUELS MA LPC

MEDICARE: EMILY SAMUELS MA LPC
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
1101YM0800XMental Health Counselor6401017578MI

General Provider Information

NPI Number : 1891247185
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY SAMUELS MA LPC
Provider Business Mailing Address
First Line : 3424 CHICAGO DR
Second Line :
City : HUDSONVILLE
State : MI
Zip : 49426-1408
Country : US
Telephone Number : 616-426-9034
Fax Number :
Provider Business Practice Location Address
First Line : 3424 CHICAGO DR
Second Line :
City : HUDSONVILLE
State : MI
Zip : 49426-1408
Country : US
Telephone Number : 616-426-9034
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2016
Last Update Date : 09/01/2023

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