CHINYERE SAMPSON (LPC, CAADC) – Professional Counselor, NPI 1104295773

CHINYERE SAMPSON (LPC, CAADC) is a healthcare provider. based in Jackson, Michigan. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC, CAADC. They hold a License No. L913196 (MI). The NPI Number for CHINYERE SAMPSON (LPC, CAADC) is 1104295773

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
CHINYERE SAMPSON (LPC, CAADC)
NPI
1104295773
Phone
(517) 784-2929
Address
3300 LANSING AVE
Enumeration Date
24 September 2015
Last Update Date
30 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5177891200
Graduation Year
2015 (11 years ago)
PAC ID
1557700879
Group Practice PAC ID
6406808062
Professional Enrollment ID
I20240419001513
Address ID
MI492022179JA1200XAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:10State licenses:1Digital endpointsOther names

2,023 MENTAL HEALTH COUNSELOR in MI

Provider Addresses for CHINYERE SAMPSON (LPC, CAADC)

  • 3300 LANSING AVE

    JACKSON, MI 492021621

    Phone: (517) 784-2929

    Type: Location

  • 1200 N WEST AVE

    JACKSON, MI 492022179

    Phone: (517) 789-1209

    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: 2024-04-19

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
I20240419001513IMental Health CounselorMITBD

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 49202)

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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: 6406808062View full group profile
NameSpecialtyState
Mental Health CounselorMI
-MI
Clinical Social WorkerMI
-VA
Clinical Social WorkerMI
Nurse PractitionerMI
Clinical Social WorkerMI
Mental Health CounselorMI
Nurse PractitionerMI
Mental Health CounselorFL

Reviews

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Frequently asked questions

What number should I use to identify CHINYERE SAMPSON (LPC, CAADC) for billing?
Administrative and clinical systems typically use NPI 1104295773 for CHINYERE SAMPSON (LPC, CAADC).
Is CHINYERE SAMPSON (LPC, CAADC) currently accepting referrals based on NPI status?
Registry metadata lists CHINYERE SAMPSON (LPC, CAADC) as active.
What type of care does CHINYERE SAMPSON (LPC, CAADC) provide?
CHINYERE SAMPSON (LPC, CAADC)'s profile centers on Professional Counselor. Clinical services aligned with this taxonomy classification.
Can patients visit CHINYERE SAMPSON (LPC, CAADC) in Jackson, Michigan?
For routing, start with Jackson, Michigan for CHINYERE SAMPSON (LPC, CAADC), then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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