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SAMANTHA MEDEIROS FREDERICKS CADC
NPI 1164375507
Counselor - Addiction (Substance Use Disorder) in South Portland, ME

Active since February 17, 2026
400 WESTERN AVE, SOUTH PORTLAND, ME 04106(207) 405-0003 Get Directions Write a Review

NPPES record last updated: February 17, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Samantha Medeiros Fredericks Cadc NPPES

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

SAMANTHA MEDEIROS FREDERICKS CADC (NPI 1164375507) is an individual addiction (substance use disorder) provider in South Portland, Maine, licensed in Maine (CAC9317) and active in the NPI registry since February 2026.

NPPES Registry Identity

NPI1164375507
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameSAMANTHA MEDEIROS FREDERICKSCredential: CADC
Location Address400 WESTERN AVESouth Portland, ME 04106-1704
Mailing Address400 Western AveSouth Portland, ME 04106-1704 · (207) 405-0003
Phone(207) 405-0003
Sole ProprietorNo
Enumeration DateFebruary 17, 2026
NPPES CertifiedFebruary 17, 2026
✔ NPI 1164375507 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in ME · CAC9317
400 WESTERN AVE, South Portland, ME 04106
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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.

RONALDO ROSA
Case Manager/Care Coordinator
400 WESTERN AVE
SOUTH PORTLAND, ME 04106
Cumberland County (207) 292-1306
BRIANNA WIEDERHOLD CADC
Counselor (Addiction (Substance Use Disorder))
400 WESTERN AVE
SOUTH PORTLAND, ME 04106
Cumberland County (207) 774-7111
JULIE WYONA VECCHIO CCS, LADC
Counselor (Addiction (Substance Use Disorder))
400 WESTERN AVE
SOUTH PORTLAND, ME 04106
Cumberland County (207) 774-7111
LISA ANN HODGKINS I CADC,MHRT-C
Counselor (Addiction (Substance Use Disorder))
400 WESTERN AVE
SOUTH PORTLAND, ME 04106
Cumberland County (207) 774-7111
MICAELA MANGANELLO
Preventive Medicine (Addiction Medicine)
400 WESTERN AVE
SOUTH PORTLAND, ME 04106
Cumberland County (207) 292-1306
DR. JOSEPH PY D.O.
Family Medicine (Addiction Medicine)
400 WESTERN AVE
SOUTH PORTLAND, ME 04106
Cumberland County (207) 774-7111
ERIN GARTHWAITE RN
Registered Nurse (Addiction (Substance Use Disorder))
400 WESTERN AVE
SOUTH PORTLAND, ME 04106
Cumberland County (207) 774-7111
DANIELLE JANET MILOVANOVIC
Family Medicine (Addiction Medicine)
400 WESTERN AVE
SOUTH PORTLAND, ME 04106
Cumberland County (207) 114-7111

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 Samantha Fredericks's NPI number?

The NPI number for Samantha Fredericks is 1164375507. It was assigned to this individual provider in the NPPES registry on February 17, 2026.

Where is Samantha Fredericks located?

Samantha Fredericks practices at 400 Western Ave, South Portland, ME 04106. The listed phone number is (207) 405-0003.

What is Samantha Fredericks's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Samantha Fredericks was last updated on February 17, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.