SAMANTHA WOMELDORF LADC, LPCC
NPI 1275230468
Counselor - Professional in Chaska, MN

Q: What is Samantha Womeldorf's NPI number?

The NPI number for Samantha Womeldorf is 1275230468. It was assigned to this individual provider in the NPPES registry on February 8, 2023.

Q: What is Samantha Womeldorf's specialty?

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

Active since February 08, 2023PECOS EnrolledAccepts Medicare Assignment

1045 STOUGHTON AVE, CHASKA, MN 55318(952) 448-6557(952) 448-6047 Get Directions Write a Review

NPPES record last updated: February 8, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Samantha Womeldorf Ladc, Lpcc NPPES

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

SAMANTHA WOMELDORF LADC, LPCC (NPI 1275230468) is an individual professional provider in Chaska, Minnesota, licensed in Minnesota (3690) and active in the NPI registry since February 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1275230468

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameSAMANTHA WOMELDORFCredential: LADC, LPCC

Location Address1045 STOUGHTON AVEChaska, MN 55318-2149

Mailing Address102 E 2nd StChaska, MN 55318-1906 · (952) 856-3932 · Fax (952) 448-6047

Phone(952) 448-6557

Fax(952) 448-6047

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateFebruary 8, 2023

NPPES CertifiedFebruary 8, 2023

✔ NPI 1275230468 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in MN · 3690

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 305744 (MN)

1045 STOUGHTON AVE, Chaska, MN 55318

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samantha Womeldorf Ladc, Lpcc 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 ID4981133154

PECOS Enrollment IDI20250203001165

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.

Medicare Billing Reassignments

Medicare enrollment records show Samantha Womeldorf reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Sonder Behavioral Health & Wellness, Inc.

10 mi

Clinical

12301 WHITEWATER DR, STE 101
Minnetonka, MN 55343

Reassigned Medicare billing, Minnesota enrollment
37 clinicians in this Medicare group

NPI 1780031732 (952) 999-6097

Sandsted Wellness LLC

18 mi

Professional

20855 KENSINGTON BLVD STE B201
Lakeville, MN 55044

Reassigned Medicare billing, Minnesota enrollment
6 clinicians in this Medicare group

NPI 1780553925 (612) 812-1875

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 9

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

MRS. DAWN M BUNKE MA, LPCC, LADC

Counselor (Mental Health)