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

MS. Kibasa Samuel, LCSW, CASAC, SAPMAC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1407227879

MS. Kibasa Samuel, LCSW, CASAC, SAPMAC is an Addiction (Substance Use Disorder) Counselor in Commack, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2015
Specialties on file
4
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

169 Commack Rd # 1010
Commack, NY 11725-3442
Phone: (516) 430-7372
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 090232 (NY)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 31589 (NY)
Professional Counselor Taxonomy 101YP2500X · Licence 4937560 (NY)
Social Worker Taxonomy 104100000X · Licence 72091813 (NY)

Record details

NPI number1407227879
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW , CASAC , SAPMAC
Sole proprietorYes
NPI enumeratedOctober 12, 2015
Last updated in NPPESFebruary 23, 2022
Certification dateFebruary 23, 2022

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