Individual provider Active NPI

Rosalee Ann Klingmeyer, LCPC

  • Mental Health Counselor
  • Crownsville, MD
National Provider Identifier
1407992308
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC0680 Issued in MD
Practice address
43 Community PL
Crownsville, MD 21032-2034
Phone
(410) 923-7191
Fax
(410) 923-7190
NPI assigned
Jan 29, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LC0680 MD Primary

Addresses

Primary practice location

43 Community PL
Crownsville, MD 21032-2034

Mailing address

3533 Northway Dr
Baltimore, MD 21234-7924
Phone (443) 838-1921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240709003821 NY Practitioner - Mental Health Counselor 3375088826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Counseling Center of the Mohawk Valley, Inc.Group PAC ID 8921083882, 5 clinicians

Practice addresses (Care Compare)

1612 Genesee St
Utica, NY 13502-5425
Phone (315) 724-5173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC0680MDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Counseling Center of the Mohawk Valley, Inc Mental Health CurrentSince Jun 25, 2024 Accepting new patients
Samaritan Counseling Center of the Mohawk Valley, Inc PastSince Jun 25, 2024 Accepting new patients

Locations

1612 Genesee St
Utica, NY 13502
Phone (315) 724-5173

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407992308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3533 NORTHWAY DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212347924",
            "telephone_number": "443-838-1921",
            "fax_number": "410-923-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 COMMUNITY PL",
            "city": "CROWNSVILLE",
            "state": "MD",
            "postal_code": "210322034",
            "telephone_number": "410-923-7191",
            "fax_number": "410-923-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINGMEYER",
        "first_name": "ROSALEE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC0680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crownsville, MD

Sources for this page

Verify at the official NPI Registry.