Individual provider Active NPI

Samantha Wesley Kohn, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Campbell Hall, NY
National Provider Identifier
1013018589
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
016889 Issued in NY
Practice address
3136 Route 207
Suite 107
Campbell Hall, NY 10916
Phone
(845) 283-2544
Fax
(845) 360-5834
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 016889 NY Primary

Addresses

Primary practice location

3136 Route 207
Suite 107
Campbell Hall, NY 10916

Mailing address

11 Trails Point Dr
Campbell Hall, NY 10916-2306
Phone (845) 294-9469

Other identifiers 1

IdentifierTypeStateIssuer
02812260MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061201000281 NY Practitioner - Clinical Psychologist 2860490711 Practice locations: Campbell Hall, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3136 Route 207
Suite 107
Campbell Hall, NY 10916-2230
Phone (845) 283-2544

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
016889NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Patricia R Griffin PHD Past Accepting new patients
Attainable Hope Psychology Services PLLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1013018589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 TRAILS POINT DR",
            "city": "CAMPBELL HALL",
            "state": "NY",
            "postal_code": "109162306",
            "telephone_number": "845-294-9469",
            "fax_number": "845-294-9469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3136 ROUTE 207",
            "address_2": "SUITE 107",
            "city": "CAMPBELL HALL",
            "state": "NY",
            "postal_code": "10916",
            "telephone_number": "845-283-2544",
            "fax_number": "845-360-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHN",
        "first_name": "SAMANTHA",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "016889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02812260",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell Hall, NY

Sources for this page

Verify at the official NPI Registry.