Individual provider Active NPI

Samantha Baillie, MA LPC

  • Mental Health Counselor
  • Cranberry TWP, PA
National Provider Identifier
1053647990
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC009083 Issued in PA
Practice address
125 Emeryville Dr Ste 230
Cranberry TWP, PA 16066-5020
Phone
(724) 609-5002
Fax
(724) 299-8964
NPI assigned
Oct 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC009083 PA Primary
Counselor 101Y00000X 678 WY
Counselor 101Y00000X 1339 WY
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

125 Emeryville Dr Ste 230
Cranberry TWP, PA 16066-5020

Mailing address

125 Emeryville Dr Ste 230
Cranberry TWP, PA 16066-5020
Phone (724) 609-5002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240516000752 PA Practitioner - Mental Health Counselor 6204277676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Counseling Center of Western PAGroup PAC ID 3678826476, 12 clinicians

Practice addresses (Care Compare)

202 Beaver St
FL 3
Sewickley, PA 15143-1230
Phone 41274174301002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PC009083PAMDMental Health Counselor
678WYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Counseling Center of Western PA CurrentSince Aug 5, 2024 Accepting new patients

Locations

5475 William Flynn Hwy
Ste 304
Gibsonia, PA 15044
Phone (888) 200-9746

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1053647990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 EMERYVILLE DR STE 230",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160665020",
            "telephone_number": "724-609-5002",
            "fax_number": "724-299-8964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 EMERYVILLE DR STE 230",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160665020",
            "telephone_number": "724-609-5002",
            "fax_number": "724-299-8964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILLIE",
        "first_name": "SAMANTHA",
        "credential": "MA LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-28",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC009083",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WY",
            "license": "678",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WY",
            "license": "1339",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranberry TWP, PA

Sources for this page

Verify at the official NPI Registry.