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SAMANTHA K NELSON MA, LPC-MHSP
NPI 1659077428
Counselor - Professional in Johnson City, TN

Active since February 03, 2023PECOS Enrolled
109 W WATAUGA AVE, JOHNSON CITY, TN 37604(423) 232-2600(423) 467-3644 Get Directions Write a Review

NPPES record last updated: July 6, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 6, 2023, Feb 3, 2023 (2 updates tracked since 2023).

About Samantha K Nelson Ma, Lpc-mhsp NPPES

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

SAMANTHA K NELSON MA, LPC-MHSP (NPI 1659077428) is an individual professional provider in Johnson City, Tennessee, licensed in Tennessee (5877) and active in the NPI registry since February 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1659077428
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameSAMANTHA K NELSONCredential: MA, LPC-MHSP
Location Address109 W WATAUGA AVEJohnson City, TN 37604-5668
Mailing Address1167 Spratlin Park DrGray, TN 37615-6205 · (423) 467-3724 · Fax (423) 467-3644
Phone(423) 232-2600
Fax(423) 467-3644
Sole ProprietorNo
Enumeration DateFebruary 3, 2023
Last NPPES UpdateJuly 6, 20232 updates tracked since enumeration
NPPES CertifiedJuly 6, 2023
✔ NPI 1659077428 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 TN · 5877
109 W WATAUGA AVE, Johnson City, TN 37604
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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 K Nelson Ma, Lpc-mhsp 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.

JACQUELINE KATKO BS
Case Manager/Care Coordinator
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2600
MATTHEW M MIDKIFF LPC, MHSP
Counselor (Professional)
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2600
KIM MARIE DICKSON BACHELORS
Case Manager/Care Coordinator
109 W WATAUGA AVE, WATAUGA BEHAVIORAL HEALTH
JOHNSON CITY, TN 37604
Washington County (423) 232-2788
MR. JONATHAN JUNIOR PERKINS MED
Counselor
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2600
HANNAH T SHANNON LPC/ MHSP
Counselor (Professional)
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2600
HALEY N CIGARROA LPC/ MHSP
Counselor (Professional)
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2600
ISAAC LEE MARTIN JR. MRC CRC
Personal Emergency Response Attendant
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2600
ADAM WAYNE DAVIS
Case Manager/Care Coordinator
109 W WATAUGA AVE
JOHNSON CITY, TN 37604
Washington County (423) 232-2600

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 Nelson's NPI number?

The NPI number for Samantha Nelson is 1659077428. It was assigned to this individual provider in the NPPES registry on February 3, 2023.

Where is Samantha Nelson located?

Samantha Nelson practices at 109 W Watauga Ave, Johnson City, TN 37604. The listed phone number is (423) 232-2600.

What is Samantha Nelson's specialty?

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

Is Samantha Nelson enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Samantha Nelson was last updated on July 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.