NATALIA SAMUDOVSKY LCPC
NPI 1649752403
Counselor - Professional in Boise, ID

Q: What is Natalia Samudovsky's NPI number?

The NPI number for Natalia Samudovsky is 1649752403. It was assigned to this individual provider in the NPPES registry on August 29, 2018.

Q: What is Natalia Samudovsky's specialty?

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

Active since August 29, 2018PECOS Enrolled

12553 W EXPLORER DR STE 190, BOISE, ID 83713(208) 376-7083(208) 321-5069 Get Directions Write a Review

NPPES record last updated: August 1, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Natalia Samudovsky Lcpc NPPES

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

NATALIA SAMUDOVSKY LCPC (NPI 1649752403) is an individual professional provider in Boise, Idaho, licensed in Idaho (9023) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1649752403

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameNATALIA SAMUDOVSKYCredential: LCPC

Location Address12553 W EXPLORER DR STE 190Boise, ID 83713-1612

Mailing Address12553 W Explorer Dr Ste 190Boise, ID 83713-1612 · (208) 376-7083 · Fax (208) 321-5069

Phone(208) 376-7083

Fax(208) 321-5069

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateAugust 29, 2018

Last NPPES UpdateAugust 1, 2023

NPPES CertifiedAugust 1, 2023

✔ NPI 1649752403 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in ID · 9023

Also ListedCounselorTaxonomy 101Y00000X · License 6969 (ID)

12553 W EXPLORER DR STE 190, Boise, ID 83713

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Natalia Samudovsky Lcpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4284129594

PECOS Enrollment IDI20251223003198

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.

AMBER LAROCCO CADC

Peer Specialist