SAMANTHA-JO DEITRICK MA, LBS, NCC - NPI 1356107908

Q: What is Samantha-jo Deitrick's NPI number?

The NPI number for Samantha-jo Deitrick is 1356107908. It was assigned to this individual provider in the NPPES registry on February 22, 2024.

Q: What is Samantha-jo Deitrick's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

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About Samantha-jo Deitrick Ma, Lbs, Ncc NPPES

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

SAMANTHA-JO DEITRICK MA, LBS, NCC (NPI 1356107908) is an individual counselor in Aliquippa, Pennsylvania, licensed in Pennsylvania (PC018854) and active in the NPI registry since February 2024. She is enrolled in Medicare PECOS, maintains a secondary practice location in Warrendale, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1356107908

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameSAMANTHA-JO DEITRICKCredential: MA, LBS, NCC

Location Address150 PLEASANT DR STE 201Aliquippa, PA 15001-1360

Mailing Address145 Lynn Haven DrBeaver, PA 15009-1335 · (724) 664-7445

Phone(724) 888-2097

Fax(724) 888-2098

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateFebruary 22, 2024

Last NPPES UpdateApril 21, 2026

NPPES CertifiedApril 21, 2026

✔ NPI 1356107908 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

License✔ Licensed in PA · PC018854

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

150 PLEASANT DR STE 201, Aliquippa, PA 15001

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Secondary Practice Location 1

Location 11 Williamsburg Pl Ste G2Warrendale, PA 15086-7519 · Phone (216) 282-7355

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha-jo Deitrick Ma, Lbs, Ncc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8325546336

PECOS Enrollment IDI20250808003688

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.

Other Providers at the Same Location NPPES 5

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

MS. MELISSA CHRISTINE DONOHUE MSW, LCSW

Counselor (Professional)