JASON MARTIN SAMUDIO
NPI 1215494158
Counselor - Addiction (Substance Use Disorder) in Maple Grove, MN

Active since February 27, 2019
13603 80TH CIR N, MAPLE GROVE, MN 55369(763) 274-3120(763) 274-3121 Get Directions Write a Review

NPPES record last updated: February 27, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jason Martin Samudio NPPES

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

JASON MARTIN SAMUDIO (NPI 1215494158) is an individual addiction (substance use disorder) provider in Maple Grove, Minnesota, licensed in Minnesota (305317) and active in the NPI registry since February 2019.

NPPES Registry Identity

NPI1215494158
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameJASON MARTIN SAMUDIO
Location Address13603 80TH CIR NMaple Grove, MN 55369-8961
Mailing Address1900 Silver Lake Rd Nw Ste 110New Brighton, MN 55112-1789 · (651) 628-9566 · Fax (651) 628-0411
Fax(763) 274-3121
Sole ProprietorNo
Enumeration DateFebruary 27, 2019
NPI 1215494158 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 MN · 305317
13603 80TH CIR N, Maple Grove, MN 55369

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.

Marriage & Family Therapist
13603 80TH CIR N
MAPLE GROVE, MN 55369
Psychiatry & Neurology (Psychiatry)
13603 80TH CIR N
MAPLE GROVE, MN 55369
Social Worker (Clinical)
13603 80TH CIR N
MAPLE GROVE, MN 55369
Counselor (Addiction (Substance Use Disorder))
13603 80TH CIR N
MAPLE GROVE, MN 55369
Counselor (Mental Health)
13603 80TH CIR N
MAPLE GROVE, MN 55369
Marriage & Family Therapist
13603 80TH CIR N
MAPLE GROVE, MN 55369
Counselor (Mental Health)
13603 80TH CIR N
MAPLE GROVE, MN 55369
Psychologist (Counseling)
13603 80TH CIR N
MAPLE GROVE, MN 55369

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 Jason Samudio's NPI number?

The NPI number for Jason Samudio is 1215494158. It was assigned to this individual provider in the NPPES registry on February 27, 2019.

Where is Jason Samudio located?

Jason Samudio practices at 13603 80th Cir N, Maple Grove, MN 55369. The listed phone number is (763) 274-3120.

What is Jason Samudio'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 Jason Samudio was last updated on February 27, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.