Individual provider · Type 1 NPI

Samantha Medeiros Fredericks, CADC

Addiction (Substance Use Disorder) Counselor · South Portland, ME

NPI number 1164375507 Active

Practice location

400 Western Ave
South Portland, ME 04106-1704

Call (207) 405-0003 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XCAC9317 (ME)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1164375507

Samantha Medeiros Fredericks, CADC's National Provider Identifier is 1164375507, issued on Feb 17, 2026. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in South Portland, ME. The record was last updated on Feb 17, 2026.