Active NPI
Samantha Corn
- Mental Health Counselor
- Crested Butte, CO
National Provider Identifier
1023871753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 20309
- Practice address
- 503 3Rd St Ste 4
Crested Butte, CO 81224-9671 - Phone
- (970) 275-4724
- NPI assigned
- Feb 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 20309 | CO | Primary |
Addresses
Primary practice location
503 3Rd St Ste 4
Crested Butte, CO 81224-9671
Mailing address
PO Box 542
Crested Butte, CO 81224-0542
Phone (970) 275-4724
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20309 | CO | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707091200000",
"number": "1023871753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 542",
"city": "CRESTED BUTTE",
"state": "CO",
"postal_code": "812240542",
"telephone_number": "970-275-4724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "503 3RD ST STE 4",
"city": "CRESTED BUTTE",
"state": "CO",
"postal_code": "812249671",
"telephone_number": "970-275-4724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORN",
"first_name": "SAMANTHA",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-05",
"last_updated": "2024-02-05",
"certification_date": "2024-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CO",
"license": "20309",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crested Butte, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.