Individual provider Active NPI

Samantha Leblanc

  • Mental Health Counselor
  • Portland, ME
National Provider Identifier
1417527078
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC7253 Issued in ME
Practice address
615 Congress St Ste 601B
Portland, ME 04101-5361
Phone
(207) 358-9316
NPI assigned
Jun 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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 CC7253 ME Primary

Addresses

Primary practice location

615 Congress St Ste 601B
Portland, ME 04101-5361

Mailing address

615 Congress St Ste 601B
Portland, ME 04101-5361
Phone (207) 358-9316

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
CC7253MEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sam Leblanc Counseling LLC CurrentSince Oct 8, 2023 Accepting new patients
Nikki Wetherell Counseling Mental Health PastSince Jul 1, 2021 Accepting new patients

Locations

615 Congress St
Ste 601B
Portland, ME 04101
Phone (207) 358-9316

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1417527078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 CONGRESS ST STE 601B",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041015361",
            "telephone_number": "207-358-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 CONGRESS ST STE 601B",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041015361",
            "telephone_number": "207-358-9316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "CC7253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.