JACQUELINE KRISTINE SAMUELSON
NPI 1912846163
Counselor - Mental Health in Jacksonville, NC

Active since March 25, 2026
200 VALENCIA DR STE 109, JACKSONVILLE, NC 28546(910) 330-7559 Get Directions Write a Review

NPPES record last updated: May 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 13, 2026, Mar 25, 2026 (2 updates tracked since 2026).

About Jacqueline Kristine Samuelson NPPES

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

JACQUELINE KRISTINE SAMUELSON (NPI 1912846163) is an individual mental health provider in Jacksonville, North Carolina, licensed in North Carolina (A22893) and active in the NPI registry since March 2026.

NPPES Registry Identity

NPI1912846163
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJACQUELINE KRISTINE SAMUELSON
Location Address200 VALENCIA DR STE 109Jacksonville, NC 28546-6312
Mailing Address61 Cedar Grove CtClayton, NC 27527-7006 · (661) 618-9101
Sole ProprietorNo
Enumeration DateMarch 25, 2026
Last NPPES UpdateMay 13, 20262 updates tracked since enumeration
NPPES CertifiedMay 13, 2026
NPI 1912846163 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 · A22893
200 VALENCIA DR STE 109, Jacksonville, NC 28546

Other Providers at the Same Location NPPES 3

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

Social Worker (Clinical)
200 VALENCIA DR STE 109
JACKSONVILLE, NC 28546
Social Worker (Clinical)
200 VALENCIA DR STE 109
JACKSONVILLE, NC 28546
Social Worker (Clinical)
200 VALENCIA DR STE 109
JACKSONVILLE, NC 28546

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 Jacqueline Samuelson's NPI number?

The NPI number for Jacqueline Samuelson is 1912846163. It was assigned to this individual provider in the NPPES registry on March 25, 2026.

Where is Jacqueline Samuelson located?

Jacqueline Samuelson practices at 200 Valencia Dr Ste 109, Jacksonville, NC 28546. The listed phone number is (910) 330-7559.

What is Jacqueline Samuelson's specialty?

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

When was this NPI record last updated?

The NPPES record for Jacqueline Samuelson was last updated on May 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.