Samson Kernisant

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

425 Pleasant St Ste 104
Brockton, MA 02301-2533

Phone

(508) 269-9695

Fax

(508) 425-3048

NPI assigned

Jun 16, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Healthy Male Institute LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brockton, MA
  • NPI 1144796491
  NPD (past)

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

{
    "created_epoch": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1154217222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 PLEASANT ST STE 104",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012533",
            "telephone_number": "508-269-9695",
            "fax_number": "508-425-3048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 PLEASANT ST STE 104",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012533",
            "telephone_number": "508-269-9695",
            "fax_number": "508-425-3048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERNISANT",
        "first_name": "SAMSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-16",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William H Kennedy
• Cori Kenney
• Sarah Elizabeth Keohane
• Amanda Keough
• Kristyn Kerivan
• Leahna Kerrigan
• Alan R. Kershaw, R.PH.
• Howard Kesselman, MD
• Michael Key, LICSW
• Humaira Khalid

• Clinical Social Worker in Brockton, MA
• Providers in Brockton, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.