Samata Behavioral Health and Wellness Institute, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

SAMATA BEHAVIORAL HEALTH AND WELLNESS INSTITUTE, LLC

Practice address

128 S Main St
Enterprise, AL 36330-2543

Phone

(844) 472-6282

Fax

(855) 626-0476

NPI assigned

Dec 2, 2019

Last updated

Dec 10, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephanie Ann Kraczkowski, LPCNPI 1275073330

Title

Owner

Phone

(334) 470-9395

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephanie Ann Kraczkowski, MED

  • Professional Counselor
  • Enterprise, AL
  • NPI 1275073330
  NPD Authorized official
• Emily Pritchett, LICSW

  • Mental Health Counselor
  • Enterprise, AL
  • NPI 1689347676
  NPD

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575936000000",
    "number": "1437796067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 S MAIN ST",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302543",
            "telephone_number": "844-472-6282",
            "fax_number": "855-626-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 S MAIN ST",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302543",
            "telephone_number": "844-472-6282",
            "fax_number": "855-626-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMATA BEHAVIORAL HEALTH AND WELLNESS INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-02",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A",
        "authorized_official_last_name": "KRACZKOWSKI",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-470-9395",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Enterprise, AL
• Providers in Enterprise, AL by specialty
• Professional Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; 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.