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SAMANTHA CARROLL LPC
NPI 1629830211
Counselor - Professional in Decatur, IL

Active since January 29, 2024PECOS Enrolled
151 N MAIN ST, DECATUR, IL 62523(217) 362-6262(217) 362-6290 Get Directions Write a Review

NPPES record last updated: September 30, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Samantha Carroll Lpc NPPES

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

SAMANTHA CARROLL LPC (NPI 1629830211) is an individual professional provider in Decatur, Illinois, licensed in Illinois (179.019203) and active in the NPI registry since January 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629830211
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameSAMANTHA CARROLLCredential: LPC
Location Address151 N MAIN STDecatur, IL 62523-1206
Mailing Address151 N Main StDecatur, IL 62523-1206 · (217) 362-6262
Phone(217) 362-6262
Fax(217) 362-6290
Sole ProprietorYes
Enumeration DateJanuary 29, 2024
Last NPPES UpdateSeptember 30, 2025
NPPES CertifiedSeptember 30, 2025
✔ NPI 1629830211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in IL · 179.019203
151 N MAIN ST, Decatur, IL 62523
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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 Carroll Lpc 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.

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.

CARRIE A RAY
Counselor (Professional)
151 N MAIN ST
DECATUR, IL 62523
Macon County (217) 362-6262
CATHY JOHANSEN L.P.N.
Licensed Practical Nurse
151 N MAIN ST
DECATUR, IL 62523
Macon County (217) 362-6262
MATYA LEANN RILEY FNP-C
Nurse Practitioner (Family)
151 N MAIN ST
DECATUR, IL 62523
Macon County (217) 362-6262
ADDIE L SMITH LSW
Social Worker
151 N MAIN ST
DECATUR, IL 62523
Macon County (217) 362-6262
BARBARA L PICKETT
Licensed Practical Nurse
151 N MAIN ST
DECATUR, IL 62523
Macon County (217) 362-6262
HERITAGE BEHAVIORAL HEALTH CENTER INC.
Clinic/Center (Primary Care)
151 N MAIN ST
DECATUR, IL 62523
Macon County (217) 362-6262
MICHELLE HANSON LCPC
Counselor (Professional)
151 N MAIN ST
DECATUR, IL 62523
Macon County (217) 362-6262
LESA J MCMAHON-LOWE LCPC
Counselor (Professional)
151 N MAIN ST
DECATUR, IL 62523
Macon County (217) 420-4776

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 Carroll's NPI number?

The NPI number for Samantha Carroll is 1629830211. It was assigned to this individual provider in the NPPES registry on January 29, 2024.

Where is Samantha Carroll located?

Samantha Carroll practices at 151 N Main St, Decatur, IL 62523. The listed phone number is (217) 362-6262.

What is Samantha Carroll's specialty?

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

Is Samantha Carroll enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Samantha Carroll was last updated on September 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.