Samantha Divietro

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

009481-01 Issued in NY

Practice address

230 North Rd
Poughkeepsie, NY 12601-1328

Phone

(845) 486-2703

Fax

(845) 625-1679

NPI assigned

Jan 16, 2018

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

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

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Riverview Psychiatric Medicine, PCGroup PAC ID 6901395342, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Riverview Psychiatric Medicine PC

  • Adult Mental Health Clinic/Center
  • Poughkeepsie, NY
  • NPI 1174789812
  Medicare reassignment Care Compare group NPD
• Riverview Psychiatric Medicine, PC

  • Psychiatry Physician
  • Poughkeepsie, NY
  • NPI 1881005460
  NPD (past)

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1497263131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 NORTH RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011328",
            "telephone_number": "845-486-2703",
            "fax_number": "845-625-1679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 NORTH RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126011328",
            "telephone_number": "845-486-2703",
            "fax_number": "845-625-1679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVIETRO",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-16",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "009481-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Dittelman-Procopis, MA, CCC/SLP
• Joyce Fraleigh Dittenhoefer, AUD
• Timothy A Dittenhoefer, RPH
• John Eric Ditzenberger, MD
• Gabrielle Louise Divernieri
• Patricia Divito, M.S.,CCC-SLP
• Isabella Dixon
• Tasha Dixon
• Tiffany DO, DDS
• Sharon Doane, LCSW

• Mental Health Counselor in Poughkeepsie, NY
• Providers in Poughkeepsie, 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 May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.