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

Mr. Paul Timothy Samuelson, LPC

Individual provider Professional Counselor · NPI 1134442502

Mr. Paul Timothy Samuelson, LPC is a Mental Health Counselor in Grand Rapids, Michigan. Qualified in 2005, 21 years ago. Practices with Pine Rest Christian Mental Health Services, a 353-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
21
Licensed in
MI
In the registry since
2010
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

300 68th St SE
Grand Rapids, MI 49548-6927
Phone: (616) 258-7467
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 6401009994 (MI)

Record details

NPI number1134442502
Entity typeIndividual (Type 1)
GenderMale
Credentials LPC
Sole proprietorYes
NPI enumeratedMarch 12, 2010
Last updated in NPPESJanuary 5, 2024
Certification dateJanuary 5, 2024

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Pine Rest Christian Mental Health Services — 353 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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