Individual provider Active NPI

Samantha S Cowper, MA PPC

  • Counselor
  • Laramie, WY
National Provider Identifier
1013214105
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
581 Issued in WY
Practice address
1263 N 15TH St
Laramie, WY 82072-2343
Phone
(307) 745-8915
Fax
(307) 745-8761
NPI assigned
Feb 25, 2011
Last updated
Mar 15, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 581 WY Primary

Addresses

Primary practice location

1263 N 15TH St
Laramie, WY 82072-2343

Mailing address

1263 N 15TH St
Laramie, WY 82072-2343
Phone (307) 745-8915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20241230002015 CO Practitioner - Mental Health Counselor 6507393774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Samantha Ivy LLCGroup PAC ID 0840552386, 12 clinicians

Practice addresses (Care Compare)

6863 Johnson St
Arvada, CO 80004-2948
Phone (954) 253-1072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
581WYMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Samantha Ivy LLC CurrentSince Dec 26, 2024 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1298592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1013214105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1263 N 15TH ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820722343",
            "telephone_number": "307-745-8915",
            "fax_number": "307-745-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1263 N 15TH ST",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820722343",
            "telephone_number": "307-745-8915",
            "fax_number": "307-745-8761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWPER",
        "first_name": "SAMANTHA",
        "middle_name": "S",
        "credential": "MA PPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-25",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WY",
            "license": "581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

Verify at the official NPI Registry.