SHACKOLA SAMANTHA SYMONS LMHC, NCC
NPI 1255842464
Counselor - Mental Health in New Rochelle, NY
About Shackola Samantha Symons Lmhc, Ncc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHACKOLA SAMANTHA SYMONS LMHC, NCC (NPI 1255842464) is an individual mental health provider in New Rochelle, New York, licensed in New York (006456-1) and active in the NPI registry since October 2017. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shackola Samantha Symons Lmhc, Ncc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Shackola Symons reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Miami, FL 33130
- Reassigned Medicare billing, New York enrollment
- 867 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
NEW ROCHELLE, NY 10801
NEW ROCHELLE, NY 10801
NEW ROCHELLE, NY 10801
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 Shackola Symons's NPI number?
The NPI number for Shackola Symons is 1255842464. It was assigned to this individual provider in the NPPES registry on October 14, 2017.
Where is Shackola Symons located?
Shackola Symons practices at 481 Main St, New Rochelle, NY 10801. The listed phone number is (914) 355-2440.
What is Shackola Symons's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Shackola Symons enrolled in Medicare?
Yes. Shackola Symons is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Shackola Symons's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shackola Symons reassigns Medicare benefits to Grow Healthcare Group PA (Miami, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shackola Symons's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Shackola Symons was last updated on October 14, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Shackola Samantha Symons, LMHC, NCC · NPI 1255842464
Mental Health provider in New Rochelle, New York. Individual provider, active in the CMS NPPES registry since October 14, 2017.
## Identity
- **NPI:** 1255842464 (Entity type: Individual)
- **Enumerated:** October 14, 2017
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 006456-1 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 481 MAIN ST, New Rochelle, NY 10801-6324
- **Phone:** (914) 355-2440
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Grow Healthcare Group PA (NPI 1245845932, Miami, FL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 14, 2017
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Source: [NPI Profile](https://npiprofile.com/npi/1255842464) · Data from the CMS NPPES public registry.