Individual provider Active NPI

Samantha Cronin, LMHC

  • Mental Health Counselor
  • Yarmouth Port, MA
National Provider Identifier
1245836394
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11969 Issued in MA
Practice address
714 Main St Unit 714-C
Yarmouth Port, MA 02675-2000
Phone
(617) 869-3740
Fax
(508) 433-1871
NPI assigned
Dec 4, 2020
Last updated
Dec 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 11969 MA Primary

Addresses

Primary practice location

714 Main St Unit 714-C
Yarmouth Port, MA 02675-2000

Mailing address

714 Main St Unit 714-C
Yarmouth Port, MA 02675-2000
Phone (617) 869-3740

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

LicenseStateTypeSpecialty
11969MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Psychotherapy Associates LLC CurrentSince Dec 6, 2020 Accepting new patients
Melissa Hyer-Mitchell Psychotherapy LLC Mental Health PastSince Dec 6, 2020 Accepting new patients

Locations

714 Main St
Unit 714C
Yarmouth Port, MA 02675
Phone (508) 492-8647

Organizations & group practices 2

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": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1245836394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 MAIN ST UNIT 714-C",
            "city": "YARMOUTH PORT",
            "state": "MA",
            "postal_code": "026752000",
            "telephone_number": "617-869-3740",
            "fax_number": "508-433-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 MAIN ST UNIT 714-C",
            "city": "YARMOUTH PORT",
            "state": "MA",
            "postal_code": "026752000",
            "telephone_number": "617-869-3740",
            "fax_number": "508-433-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRONIN",
        "first_name": "SAMANTHA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-04",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "11969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yarmouth Port, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; 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.