SAMANTHA BREYFOGLE LPC, LMFT - NPI 1922836394 - Counselor in Fayetteville, AR

Q: What is Samantha Breyfogle's NPI number?

The NPI number for Samantha Breyfogle is 1922836394. It was assigned to this individual provider in the NPPES registry on July 25, 2024.

Q: What is Samantha Breyfogle's specialty?

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

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About Samantha Breyfogle Lpc, Lmft NPPES

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

SAMANTHA BREYFOGLE LPC, LMFT (NPI 1922836394) is an individual mental health provider in Fayetteville, Arkansas, licensed in Arkansas (P2405006) and active in the NPI registry since July 2024. She is enrolled in Medicare PECOS, maintains a secondary practice location in Springdale, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1922836394

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameSAMANTHA BREYFOGLECredential: LPC, LMFT

Location Address3425 N FUTRALL DRFayetteville, AR 72703-4811

Mailing Address1900 Kimbrough St Apt ASpringdale, AR 72762-1523 · (479) 800-1555

Phone(479) 713-8000

Fax(479) 713-8375

Sole ProprietorYes

Medical School CMSOtherGraduated 2022

Enumeration DateJuly 25, 2024

Last NPPES UpdateMarch 13, 20252 updates tracked since enumeration

NPPES CertifiedMarch 12, 2025

✔ NPI 1922836394 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in AR · P2405006

Also ListedMarriage & Family TherapistTaxonomy 106H00000X · License M2406004 (AR)

3425 N FUTRALL DR, Fayetteville, AR 72703

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Secondary Practice Location 1

Location 11900 Kimbrough St Apt ASpringdale, AR 72762-1523 · Phone (479) 800-1555

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Arkansas Blue Cross and Blue Shield, Health Advantage, Octave.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)

Samantha Breyfogle Lpc, Lmft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6002341674

PECOS Enrollment IDI20241120001749

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 8

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

KYLE MITCHELL CAMP MD

Psychiatry & Neurology (Psychiatry)