Provider Demographics
NPI:1740877125
Name:ONYEWUMBU, SAMUEL (LICDC,PMC, MCAP)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:ONYEWUMBU
Suffix:
Gender:M
Credentials:LICDC,PMC, MCAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 CITRUS PARK LN
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-1855
Mailing Address - Country:US
Mailing Address - Phone:561-574-7900
Mailing Address - Fax:
Practice Address - Street 1:1420 WILLOW PASS RD # 200
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5823
Practice Address - Country:US
Practice Address - Phone:925-646-5480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-31
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0010554101YA0400X
FL2233101YM0800X
OH162708225400000X
FL0802589405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No405300000XOther Service ProvidersPrevention Professional