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Active NPI 1003776238 Individual Practitioner Male Practitioner

Samuel Bommarito , INTERN

Counselor • Jackson, MI

Professional Overview & Biography Verified Profile Summary

Samuel Bommarito, INTERN is a registered healthcare professional specializing in Counselor in Jackson, MI. Practice services are available at 300 W WASHINGTON AVE STE 210B under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

300 W Washington Ave Ste 210b

Jackson, MI 492012160

Telephone 5173440913
Fax 5179056007
Associated Practice Facility / Clinic
🏢 Irwin Counseling Service Pllc Facility NPI 1164946422

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Jackson, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.8 Yrs
State Avg: 14.9 Yrs
Regional Practice Density
67 Specialists

Practicing in Jackson, MI (2610 Statewide)

Telehealth Adoption Rate
3.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-11-11
Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

18 Associated Practitioners
Geraldine San Juan-Dunford , MA LPC

Counselor - Professional

NPI 1073119988

MALPC

NPI 1114625076

LPCINTERN

Catherine Upham , LLMSW

Social Worker - Clinical

NPI 1124910955

Limited Licensed Master Social Worker

NPI 1154029007

Licensed Professional Counselor

NPI 1194423848

Licensed Professional Counselor

Scott Stark , LPC

Counselor - Mental Health

NPI 1215405360

Licensed Professional Counselor

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active November 11, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location November 11, 2025

Registered at 300 W WASHINGTON AVE STE 210B, JACKSON, MI 492012160 (Tel: 5173440913)

📍
Updated Business Mailing Address November 11, 2025

Registered at 300 W WASHINGTON AVE STE 210B, JACKSON, MI 492012160 (Tel: 5173440913)

👤
Provider Name / Credentials Updated November 11, 2025

Recorded as SAMUEL BOMMARITO, INTERN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 11, 2025

Counselor

🟢
Initial NPI Registration & Enumeration November 11, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1003776238
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 11, 2025
Last Update: November 11, 2025
Sole Proprietor: Yes

Mailing Address

300 W Washington Ave Ste 210b

Jackson, MI 492012160

Phone: 5173440913

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.