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MS. SAMANTHA D TYREE MA, LPC
NPI 1255780102
Counselor - Professional in Minooka, IL

Active since June 10, 2016PECOS EnrolledAccepts Medicare Assignment
109 WHITE LN, APT 1, MINOOKA, IL 60447(815) 955-9068 Get Directions Write a Review

NPPES record last updated: June 10, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ms. Samantha D Tyree Ma, Lpc NPPES

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

MS. SAMANTHA D TYREE MA, LPC (NPI 1255780102) is an individual professional provider in Minooka, Illinois, licensed in Illinois (178.012030) and active in the NPI registry since June 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1255780102
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMS. SAMANTHA D TYREECredential: MA, LPC
Location Address109 WHITE LN, APT 1Minooka, IL 60447-9307
Mailing Address109 White Ln, Apt 1Minooka, IL 60447-9307 · (815) 955-9068
Phone(815) 955-9068
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateJune 10, 2016
✔ NPI 1255780102 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 IL · 178.012030
109 WHITE LN, Minooka, IL 60447
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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

Ms. Samantha D Tyree Ma, 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 ID6709223126
PECOS Enrollment IDI20240321001073
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.

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 Tyree's NPI number?

The NPI number for Samantha Tyree is 1255780102. It was assigned to this individual provider in the NPPES registry on June 10, 2016.

Where is Samantha Tyree located?

Samantha Tyree practices at 109 White Ln Apt 1, Minooka, IL 60447. The listed phone number is (815) 955-9068.

What is Samantha Tyree's specialty?

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

Is Samantha Tyree enrolled in Medicare?

Yes. Samantha Tyree 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.

When was this NPI record last updated?

The NPPES record for Samantha Tyree was last updated on June 10, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.