Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ketluimar Vallecillo Samot

Individual provider Mental Health Counselor · NPI 1518718204

Ketluimar Vallecillo Samot is a Mental Health Counselor in Minneola, Florida. Qualified in 2018, 8 years ago. Licensed in Florida.

Years since qualifying
8
Licensed in
FL
In the registry since
2024

Practice location Address checks out

912 Roanoke Dr
Minneola, FL 34715-7442
Phone: (434) 665-4822
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 22214 (FL)

Record details

NPI number1518718204
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 29, 2024
Last updated in NPPESMarch 29, 2024
Certification dateMarch 29, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Minneola