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SAMANTHA VILLARREAL
NPI 1407401391
Counselor - Mental Health in Fort Worth, TX

Active since August 07, 2019Opted out of Medicare · through Apr 1, 2027
6421 CAMP BOWIE BLVD STE 401B, FORT WORTH, TX 76116(817) 438-0665 Get Directions Write a Review

NPPES record last updated: May 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 8, 2025, Aug 7, 2019 (2 updates tracked since 2019).

About Samantha Villarreal NPPES

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

SAMANTHA VILLARREAL (NPI 1407401391) is an individual mental health provider in Fort Worth, Texas, licensed in Texas (90772) and active in the NPI registry since August 2019. She has opted out of Medicare through April 1, 2027.

NPPES Registry Identity

NPI1407401391
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameSAMANTHA VILLARREAL
Location Address6421 CAMP BOWIE BLVD STE 401BFort Worth, TX 76116-5422
Mailing Address5900 Balcones Dr Ste 100Austin, TX 78731-4298 · (682) 553-7163
Phone(817) 438-0665
Sole ProprietorNo
Enumeration DateAugust 7, 2019
Last NPPES UpdateMay 8, 20252 updates tracked since enumeration
NPPES CertifiedMay 8, 2025
✔ NPI 1407401391 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in TX · 90772
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 16455 (TX)
Also ListedBehavior TechnicianTaxonomy 106S00000X
6421 CAMP BOWIE BLVD STE 401B, Fort Worth, TX 76116
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Samantha Villarreal has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2025 through April 1, 2027.

Opt-Out Effective DateApril 1, 2025
Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

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

ROOT AND EMBER COUNSELING PLLC
Counselor (Mental Health)
6421 CAMP BOWIE BLVD STE 401B
FORT WORTH, TX 76116
Tarrant County (817) 438-0665

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 Villarreal's NPI number?

The NPI number for Samantha Villarreal is 1407401391. It was assigned to this individual provider in the NPPES registry on August 7, 2019.

Where is Samantha Villarreal located?

Samantha Villarreal practices at 6421 Camp Bowie Blvd Ste 401B, Fort Worth, TX 76116. The listed phone number is (817) 438-0665.

What is Samantha Villarreal's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Samantha Villarreal enrolled in Medicare?

No. Samantha Villarreal has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Samantha Villarreal was last updated on May 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.