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MR. PAUL TIMOTHY SAMUELSON LPC
NPI 1134442502
Counselor - Professional in Grand Rapids, MI

Active since March 12, 2010PECOS EnrolledAccepts Medicare Assignment
300 68TH ST SE, GRAND RAPIDS, MI 49548(616) 258-7467 Get Directions Write a Review

NPPES record last updated: January 5, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 5, 2024, Dec 14, 2017 (2 updates tracked since 2017).

About Mr. Paul Timothy Samuelson Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. PAUL TIMOTHY SAMUELSON LPC (NPI 1134442502) is an individual professional provider in Grand Rapids, Michigan, licensed in Michigan (6401009994) and active in the NPI registry since March 2010. He is enrolled in Medicare PECOS and is a graduate of Other (2005).

NPPES Registry Identity

NPI1134442502
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMR. PAUL TIMOTHY SAMUELSONCredential: LPC
Location Address300 68TH ST SEGrand Rapids, MI 49548-6927
Mailing Address300 68th St SeGrand Rapids, MI 49548-6927 · (616) 455-5000
Phone(616) 258-7467
Sole ProprietorYes
Medical School CMSOtherGraduated 2005
Enumeration DateMarch 12, 2010
Last NPPES UpdateJanuary 5, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 5, 2024
✔ NPI 1134442502 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MI · 6401009994
300 68TH ST SE, Grand Rapids, MI 49548
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Paul Timothy Samuelson Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971955733
PECOS Enrollment IDI20240117001357
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JILLIAN LEIGH MURRAY L.C.S.W
Social Worker (Clinical)
300 68TH ST SE
GRAND RAPIDS, MI 49548
Kent County (616) 455-5000
CANDY MCKENNEY
Social Worker
300 68TH ST SE
GRAND RAPIDS, MI 49548
Kent County (616) 455-5000
TAO CHANCE BROWN-EDWARDS
Behavior Analyst
300 68TH ST SE
GRAND RAPIDS, MI 49548
Kent County (616) 455-5000
MRS. REBECCA JOY BACK LMSW
Social Worker (Clinical)
300 68TH ST SE
GRAND RAPIDS, MI 49548
Kent County (269) 929-7342
SARA RENE QUASHNIE LLMSW
Social Worker
300 68TH ST SE
GRAND RAPIDS, MI 49548
Kent County (616) 455-5000
KIMERA RAIN HARRIS
Psychiatry & Neurology (Psychiatry)
300 68TH ST SE
GRAND RAPIDS, MI 49548
Kent County (800) 678-5500
AMY LOUISE MCGAREY MSW
Social Worker (Clinical)
300 68TH ST SE
GRAND RAPIDS, MI 49548
Kent County (616) 455-5000
JUNE BUIKEMA-TEBEAU
Counselor (Mental Health)
300 68TH ST SE
GRAND RAPIDS, MI 49548
Kent County (616) 455-5000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Paul Samuelson's NPI number?

The NPI number for Paul Samuelson is 1134442502. It was assigned to this individual provider in the NPPES registry on March 12, 2010.

Where is Paul Samuelson located?

Paul Samuelson practices at 300 68th St SE, Grand Rapids, MI 49548. The listed phone number is (616) 258-7467.

What is Paul Samuelson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Paul Samuelson enrolled in Medicare?

Yes. Paul Samuelson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Paul Samuelson accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community, Oscar Insurance Company and Priority Health and 1 other insurer list Paul Samuelson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Paul Samuelson was last updated on January 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.