DR. SAMANTHA RENEE PELCAK PH.D.
NPI 1497292619
Psychologist - Clinical in Fort Drum, NY

Q: What is Samantha Pelcak's NPI number?

The NPI number for Samantha Pelcak is 1497292619. It was assigned to this individual provider in the NPPES registry on January 25, 2017. The provider is also known as Dr. Samantha Renee Jesse Ph.D..

Q: What is Samantha Pelcak's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Pelcak was last updated on November 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.

Active since January 25, 2017

11050 MOUNT BELVEDERE BLVD, FORT DRUM, NY 13602(315) 772-0215 Get Directions Write a Review

NPPES record last updated: November 12, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Nov 12, 2024, Jan 25, 2017 (2 updates tracked since 2017).

On this page

About Dr. Samantha Renee Pelcak Ph.d. NPPES

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

DR. SAMANTHA RENEE PELCAK PH.D. (NPI 1497292619) is an individual clinical provider in Fort Drum, New York, licensed in Arizona (PSY-004732) and active in the NPI registry since January 2017.

NPPES Registry Identity

NPI1497292619

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. SAMANTHA RENEE PELCAKCredential: PH.D.

Location Address11050 MOUNT BELVEDERE BLVDFort Drum, NY 13602-5438

Mailing Address11050 Mount Belvedere BlvdFort Drum, NY 13602-5438 · (315) 772-0215

Phone(315) 772-0215

Sole ProprietorNo

Enumeration DateJanuary 25, 2017

Last NPPES UpdateNovember 12, 20242 updates tracked since enumeration

NPPES CertifiedNovember 12, 2024

✔ NPI 1497292619 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in AZ · PSY-004732

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

11050 MOUNT BELVEDERE BLVD, Fort Drum, NY 13602

Open in Google Maps ↗

Other Names 1

Former Name (1)Dr. Samantha Renee Jesse Ph.d.

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.

DR. LAUREL JARVIS PH.D.

Psychologist (Clinical)

11050 MOUNT BELVEDERE BLVD, BEHAVIORAL HEALTH DEPARTMENT, MEDDAC
FORT DRUM, NY 13602

Jefferson County (315) 772-4850

DAVID LEWIS KEYES RPA-C

Physician Assistant

11050 MOUNT BELVEDERE BLVD, USA MEDDAC CREDENTIALS
FORT DRUM, NY 13602

Jefferson County (315) 772-5508

BRADY SIMPKINS PA-C

Physician Assistant

11050 MOUNT BELVEDERE BLVD
FORT DRUM, NY 13602

Jefferson County (802) 258-0301

MS. MARY ANGELA MACCULLOCH LCSW

Social Worker (Clinical)

11050 MOUNT BELVEDERE BLVD
FORT DRUM, NY 13602

Jefferson County (315) 772-7624

DR. ISAAC P MILLS DO

Family Medicine

11050 MOUNT BELVEDERE BLVD
FORT DRUM, NY 13602

Jefferson County (315) 772-2778

SAVITRI MOTAPARTHI M.D.

Pediatrics

11050 MOUNT BELVEDERE BLVD, USA MEDDAC /CREDENTIALS
FORT DRUM, NY 13602

Jefferson County (315) 772-4025

DR. LUTHER ROSWELL WIEST D.O.

Family Medicine

11050 MOUNT BELVEDERE BLVD
FORT DRUM, NY 13602

Jefferson County (315) 772-3679

MADISON GERMAN LCSW

Social Worker (Clinical)

11050 MOUNT BELVEDERE BLVD
FORT DRUM, NY 13602

Jefferson County (315) 772-2778

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 Pelcak's NPI number?

The NPI number for Samantha Pelcak is 1497292619. It was assigned to this individual provider in the NPPES registry on January 25, 2017. The provider is also known as Dr. Samantha Renee Jesse Ph.D..

Where is Samantha Pelcak located?

Samantha Pelcak practices at 11050 Mount Belvedere Blvd, Fort Drum, NY 13602. The listed phone number is (315) 772-0215.

What is Samantha Pelcak's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Samantha Pelcak was last updated on November 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.