Active NPI
Samuel Christopher Rosa, LPC
- Professional Counselor
- Collins, MS
National Provider Identifier
1396101655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1666
- Practice address
- 1505 Sunset Rd
Collins, MS 39428-6389 - Phone
- (601) 288-4915
- NPI assigned
- Jan 1, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1666 | MS | Primary |
Addresses
Primary practice location
1505 Sunset Rd
Collins, MS 39428-6389
Mailing address
PO Box 18421
Hattiesburg, MS 39404-8400
Phone (601) 288-4915
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 |
|---|---|---|---|
| 1666 | MS | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451606400000",
"number": "1396101655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 18421",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394048400",
"telephone_number": "601-288-4915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 SUNSET RD",
"city": "COLLINS",
"state": "MS",
"postal_code": "394286389",
"telephone_number": "601-288-4915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSA",
"first_name": "SAMUEL",
"middle_name": "CHRISTOPHER",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-01-01",
"last_updated": "2016-01-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MS",
"license": "1666",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Collins, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.