SAMANTHA JO EMBRY (LPCA) – Mental Health Counselor, NPI 1902619638

SAMANTHA JO EMBRY (LPCA) is a healthcare provider. based in Caneyville, Kentucky. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPCA. They hold a License No. 287909 (KY). The NPI Number for SAMANTHA JO EMBRY (LPCA) is 1902619638

Main info

Female
3 Years Of Experience
Name
SAMANTHA JO EMBRY (LPCA)
NPI
1902619638
Phone
(270) 230-6166
Address
783 LAWRENCE HAYES RD
Enumeration Date
28 January 2025
Last Update Date
28 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2702301777
Graduation Year
2023 (3 years ago)
PAC ID
9537653860
Group Practice PAC ID
4082948070
Professional Enrollment ID
I20251212003355
Address ID
KY427541428LE346XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

862 MENTAL HEALTH COUNSELOR in KY

Provider Addresses for SAMANTHA JO EMBRY (LPCA)

  • 783 LAWRENCE HAYES RD

    CANEYVILLE, KY 427219131

    Phone: (270) 230-6166

    Type: Mailing

  • 346 S MAIN ST

    LEITCHFIELD, KY 427541428

    Phone: (270) 230-6166

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-12-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251212003355IMental Health CounselorKYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 42721)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082948070View full group profile
NameSpecialtyState
Mental Health CounselorKY
Mental Health CounselorKY
Nurse PractitionerIN
Mental Health CounselorKY
Clinical Social WorkerKY
Clinical Social WorkerKY
Mental Health CounselorKY
Marriage And Family TherapistKY
Clinical Social WorkerOH
Nurse PractitionerOH

Reviews

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Frequently asked questions

Is SAMANTHA JO EMBRY (LPCA) listed with a National Provider Identifier?
Yes — SAMANTHA JO EMBRY (LPCA) has NPI 1902619638 on file in the registry.
Active or inactive — what applies to SAMANTHA JO EMBRY (LPCA)?
You should see SAMANTHA JO EMBRY (LPCA) as active in CMS-hosted NPPES data.
What area of care is associated with SAMANTHA JO EMBRY (LPCA)?
SAMANTHA JO EMBRY (LPCA)'s record emphasizes Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Is SAMANTHA JO EMBRY (LPCA) associated with Caneyville?
Public fields place SAMANTHA JO EMBRY (LPCA) around Caneyville, Kentucky. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for SAMANTHA JO EMBRY (LPCA) is noted as January 28, 2025 where the registry provides it.

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