| Remington Samuels, Llc | |
|
13304 W Center Rd Ste 110 Omaha NE 68144-3453 | |
| (402) 683-0720 | |
| (402) 915-5066 |
| Full Name | Remington Samuels, Llc |
|---|---|
| Speciality | Counselor |
| Location | 13304 W Center Rd Ste 110, Omaha, Nebraska |
| Authorized Official Name and Position | Remington Nicole Samuels (OWNER) |
| Authorized Official Contact | 4026830720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Remington Samuels, Llc 13304 W Center Rd Ste 110 Omaha NE 68144-3453 Ph: (402) 683-0720 | Remington Samuels, Llc 13304 W Center Rd Ste 110 Omaha NE 68144-3453 Ph: (402) 683-0720 |
| NPI Number | 1932777273 |
|---|---|
| Provider Enumeration Date | 06/14/2021 |
| Last Update Date | 06/14/2021 |
| Certification Date | 06/14/2021 |
| Medicare PECOS PAC ID | 1658757711 |
|---|---|
| Medicare Enrollment ID | O20220928000336 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932777273 | NPI | - | NPPES |
| 10026878000 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Remington Samuels |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164033437 PECOS PAC ID: 2567848625 Enrollment ID: I20220928000367 |
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