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DR. SAMANTHA JO SIMON PHD, LCMHC, NCC
NPI 1588285167
Counselor - Mental Health in Raleigh, NC

Active since May 05, 2020PECOS Enrolled
2709 BLUE RIDGE RD STE 190, RALEIGH, NC 27607(984) 355-0422 Get Directions Write a Review

NPPES record last updated: January 24, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 10, 2023, May 5, 2020 (2 updates tracked since 2020).

About Dr. Samantha Jo Simon Phd, Lcmhc, Ncc NPPES

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

DR. SAMANTHA JO SIMON PHD, LCMHC, NCC (NPI 1588285167) is an individual mental health provider in Raleigh, North Carolina, licensed in North Carolina (13168) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1588285167
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameDR. SAMANTHA JO SIMONCredential: PHD, LCMHC, NCC
Location Address2709 BLUE RIDGE RD STE 190Raleigh, NC 27607-6462
Mailing Address2709 Blue Ridge Rd Ste 190Raleigh, NC 27607-6462 · (984) 355-0422
Phone(984) 355-0422
Sole ProprietorNo
Enumeration DateMay 5, 2020
Last NPPES UpdateJanuary 24, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 24, 2024
✔ NPI 1588285167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NC · 13168
2709 BLUE RIDGE RD STE 190, Raleigh, NC 27607
Open in Google Maps ↗

Other Names 1

Professional Name (2)Samantha Simon Lohorn Lcmhc

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Samantha Jo Simon Phd, Lcmhc, Ncc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Samantha Simon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Devang Family Services
Same address
Mental Health
2709 BLUE RIDGE RD STE 190
Raleigh, NC 27607
  • Reassigned Medicare billing, North Carolina enrollment
  • 5 clinicians in this Medicare group
NPI 1992410716 (571) 274-8132

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 6

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

MRS. CHARDAY MARIE BOLIVAR LCMHC, LCAS-A
Counselor (Mental Health)
2709 BLUE RIDGE RD STE 190
RALEIGH, NC 27607
Wake County (919) 877-6458
SAMANTHA HOLLAND
Social Worker (Clinical)
2709 BLUE RIDGE RD STE 190
RALEIGH, NC 27607
Wake County (919) 867-7774
LAKEISHA TAYLOR LCSW-C, LICSW, LCSW
Social Worker (Clinical)
2709 BLUE RIDGE RD STE 190
RALEIGH, NC 27607
Wake County (919) 877-6458
BRIANNA ELIZABETH MOORE
Counselor (Mental Health)
2709 BLUE RIDGE RD STE 190
RALEIGH, NC 27607
Wake County (919) 322-0140
SARAH CATHERINE FLOYD LCMHCA
Counselor (Mental Health)
2709 BLUE RIDGE RD STE 190
RALEIGH, NC 27607
Wake County (919) 877-6458
DEVANG FAMILY SERVICES
Counselor (Mental Health)
2709 BLUE RIDGE RD STE 190
RALEIGH, NC 27607
Wake County (571) 274-8132

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 Simon's NPI number?

The NPI number for Samantha Simon is 1588285167. It was assigned to this individual provider in the NPPES registry on May 5, 2020. The provider is also known as Samantha Simon Lohorn Lcmhc.

Where is Samantha Simon located?

Samantha Simon practices at 2709 Blue Ridge Rd Ste 190, Raleigh, NC 27607. The listed phone number is (984) 355-0422.

What is Samantha Simon's specialty?

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

Is Samantha Simon enrolled in Medicare?

Yes. Samantha Simon is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Samantha Simon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Simon reassigns Medicare benefits to Devang Family Services (Raleigh, NC). 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 Samantha Simon'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 Samantha Simon was last updated on January 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.