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EBONI SAMUEL
NPI 1881305464
Counselor - Professional in Grand Prairie, TX

Active since December 05, 2022PECOS Enrolled
2639 BRIDGEWATER DR, GRAND PRAIRIE, TX 75054(214) 604-6724 Get Directions Write a Review

NPPES record last updated: December 5, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Eboni Samuel NPPES

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

EBONI SAMUEL (NPI 1881305464) is an individual professional provider in Grand Prairie, Texas, licensed in Texas (79980) and active in the NPI registry since December 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1881305464
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameEBONI SAMUEL
Location Address2639 BRIDGEWATER DRGrand Prairie, TX 75054-7229
Mailing Address2639 Bridgewater DrGrand Prairie, TX 75054-7229 · (214) 604-6724
Phone(214) 604-6724
Sole ProprietorYes
Enumeration DateDecember 5, 2022
NPPES CertifiedDecember 5, 2022
✔ NPI 1881305464 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 TX · 79980
2639 BRIDGEWATER DR, Grand Prairie, TX 75054
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Oscar Insurance Company, Providence Health Plan and more.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)

Eboni Samuel 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

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

BRIDGE OVER BARRIERS COUNSELING LLC
Counselor (Professional)
2639 BRIDGEWATER DR
GRAND PRAIRIE, TX 75054
Tarrant County (214) 604-6724

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 Eboni Samuel's NPI number?

The NPI number for Eboni Samuel is 1881305464. It was assigned to this individual provider in the NPPES registry on December 5, 2022.

Where is Eboni Samuel located?

Eboni Samuel practices at 2639 Bridgewater Dr, Grand Prairie, TX 75054. The listed phone number is (214) 604-6724.

What is Eboni Samuel's specialty?

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

Is Eboni Samuel enrolled in Medicare?

Yes. Eboni Samuel is registered in the Medicare PECOS enrollment system.

What insurance does Eboni Samuel accept?

Health plans from Blue Cross and Blue Shield of Texas, Oscar Insurance Company, Providence Health Plan, UnitedHealthcare and WellPoint list Eboni Samuel as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Eboni Samuel was last updated on December 5, 2022. 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.