Active NPI
Samantha Merrill, LCPC
- Mental Health Counselor
- Auburn, ME
National Provider Identifier
1144754219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- XL4675
- Practice address
- 38 Cleaves St
Auburn, ME 04210-4218 - Phone
- (207) 743-1114
- NPI assigned
- Apr 17, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | XL4675 | ME | Primary |
Addresses
Primary practice location
38 Cleaves St
Auburn, ME 04210-4218
Mailing address
141 Ford Quint Rd
North Berwick, ME 03906-5932
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240206003641 | ME | Practitioner - Mental Health Counselor | 4183067242 | Practice locations: North Berwick, ME |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
141 Ford Quint Rd
North Berwick, ME 03906-5932
Phone (207) 743-1114
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| XL4675 | ME | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631491200000",
"number": "1144754219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 FORD QUINT RD",
"city": "NORTH BERWICK",
"state": "ME",
"postal_code": "039065932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38 CLEAVES ST",
"city": "AUBURN",
"state": "ME",
"postal_code": "042104218",
"telephone_number": "207-743-1114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRILL",
"first_name": "SAMANTHA",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-17",
"last_updated": "2021-09-13",
"certification_date": "2021-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ME",
"license": "XL4675",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.