Samantha Renee Green

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

011721 Issued in NY

Practice address

1900 Empire Blvd
Suite 184
Webster, NY 14580-1297

Phone

(585) 755-7811

NPI assigned

Sep 6, 2019

Last updated

Jul 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Samantha Green Licensed Mental Health Counseling PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Webster, NY
  • NPI 1659262053
  NPD Authorized official

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

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1437708047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 COUNTRY LN",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261029",
            "telephone_number": "585-755-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 EMPIRE BLVD",
            "address_2": "SUITE 184",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145801297",
            "telephone_number": "585-755-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "SAMANTHA",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-06",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "011721",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blase J Grayson, D.C.
• Dana Eisenberg Grayson, RN
• Greater Rochester Physical Therapy PC
• Jean A. Greco, M.S.
• Lisa Green
• Vonshay Green, LPN
• Meredith Mey Griffin, LMHC
• Bradley Patricia Griffiths-Thompson, LPN
• Grace Grillo
• Taylor Ellen Groat, PA-C

• Mental Health Counselor in Webster, NY
• Providers in Webster, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.