SAMUEL WOLDEMICHAEL – Professional Counselor, NPI 1124637863

SAMUEL WOLDEMICHAEL is a healthcare provider. based in Lanham, Maryland. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. LC10486 (MD). The NPI Number for SAMUEL WOLDEMICHAEL is 1124637863

Main info

Male
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
SAMUEL WOLDEMICHAEL
NPI
1124637863
Phone
(301) 538-5659
Address
8604 NIGHTINGALE DR
Enumeration Date
29 July 2020
Last Update Date
29 July 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8776220013
Graduation Year
2016 (10 years ago)
PAC ID
3476099151
Group Practice PAC ID
5092120030
Professional Enrollment ID
I20240718003488
Address ID
MD21771XXXXMOXXXXXXXXXX00
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

1,236 MENTAL HEALTH COUNSELOR in MD

Provider Addresses for SAMUEL WOLDEMICHAEL

  • 8604 NIGHTINGALE DR

    LANHAM, MD 207063953

    Phone: (301) 538-5659

    Type: Mailing

  • 3415 HAMILTON ST STE 9

    HYATTSVILLE, MD 207823953

    Phone: (301) 538-5659

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2024-07-18

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
I20240718003488IMental Health CounselorMDTBD

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 20706)

Loading plans...

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: 5092120030View full group profile
NameSpecialtyState
Clinical PsychologistMD
Clinical PsychologistRI
Clinical PsychologistIL
Clinical PsychologistFL
P S Y C H I A T R YFL
Clinical Social WorkerFL
P S Y C H I A T R YFL
Clinical PsychologistFL
Nurse PractitionerFL
Clinical Social WorkerMD

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Where can patients find SAMUEL WOLDEMICHAEL's NPI?
You can confirm SAMUEL WOLDEMICHAEL with NPI 1124637863; it appears in the national provider directory.
Is SAMUEL WOLDEMICHAEL currently active in the NPI registry?
CMS-published data lists SAMUEL WOLDEMICHAEL as an active registrant.
Does SAMUEL WOLDEMICHAEL list a primary specialty?
If you are matching referrals, note Professional Counselor for SAMUEL WOLDEMICHAEL. Clinical services aligned with this taxonomy classification.
What location shows for SAMUEL WOLDEMICHAEL?
We surface Lanham, Maryland for SAMUEL WOLDEMICHAEL based on available NPPES addresses.
Is SAMUEL WOLDEMICHAEL a real provider?
This page reflects official NPPES data for NPI 1124637863. Always confirm identity and privileges with the practice and licensing boards.

Similar Providers

Jenita Griffin

Community/Behavioral Health Agency
5204 DERBY MANOR LN
NPI: 1861520140

MS. CAROL NASR CARLE (LCPC)

Professional Counselor
10123 SENATE DR
NPI: 1558489005
PO BOX 983
NPI: 1518165562

JENNIFER BROOKE SHERWIN (LCPC)

Professional Counselor
10123 SENATE DR
NPI: 1649467408

DR. KATRINA N LAWRENCE (EDD, LCPC)

Counseling Psychologist
9332, Annapolis Road, Seabrook, Lanham-Seabrook, Prince George's County, Maryland, 20706, United States
NPI: 1134394125
12100, Sand Wedge Lane, Wallace Estates, Upper Marlboro, Prince George's County, Maryland, 20772, United States
NPI: 1043469430

DR. CHRISTOPHER L BAZEMORE (LCPC)

Professional Counselor
210, East Biddle Street, Midtown-Belvedere, Baltimore, Maryland, 21202, United States
NPI: 1366693962
8118 Good Luck Rd
NPI: 1104051440