Active NPI
Samantha Wary, LPC-MHSP
- Professional Counselor
- Brentwood, TN
National Provider Identifier
1427669928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 5137
- Practice address
- 103 Continental PL Ste 400
Brentwood, TN 37027-1073 - Phone
- (615) 606-3866
- NPI assigned
- Aug 10, 2020
- Sex
- Female
- 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 | 5137 | TN | Primary |
Addresses
Primary practice location
103 Continental PL Ste 400
Brentwood, TN 37027-1073
Mailing address
103 Continental PL Ste 400
Brentwood, TN 37027-1073
Phone (615) 606-3866
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 16, 2024 through Feb 16, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kairos Mental Health Cooperative | Professional | Past | Accepting new patients |
Organizations & group practices 1
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": "1597017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711584000000",
"number": "1427669928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 CONTINENTAL PL STE 400",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370271073",
"telephone_number": "615-606-3866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 CONTINENTAL PL STE 400",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370271073",
"telephone_number": "615-606-3866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARY",
"first_name": "SAMANTHA",
"credential": "LPC-MHSP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-10",
"last_updated": "2024-03-28",
"certification_date": "2024-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TN",
"license": "5137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brentwood, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.