Individual provider Active NPI

Samantha Davis

  • Mental Health Counselor
  • Salem, MA
National Provider Identifier
1538808506
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
35 Congress St Building 2 Rear
Unit 2150B
Salem, MA 01970
Phone
(781) 745-2440
NPI assigned
May 31, 2022
Last updated
May 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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 Primary

Addresses

Primary practice location

35 Congress St Building 2 Rear
Unit 2150B
Salem, MA 01970

Mailing address

35 Congress St Building 2 Rear
Unit 2150B
Salem, MA 01970
Phone (781) 745-2440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20250206000736 MA Practitioner - Mental Health Counselor 2062942089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Behavioral Health CorporationGroup PAC ID 0446155808, 42 clinicians

Practice addresses (Care Compare)

35 Congress St
Suite 2
Salem, MA 01970-5567
Phone (978) 745-2440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Behavioral Health Corporation CurrentSince Jan 6, 2025 Accepting new patients

Locations

199 Rosewood Dr
Ste 250
Danvers, MA 01923
Phone (978) 867-7756

12 Methuen St
Ste 3
Lawrence, MA 01840
Phone (978) 683-3128

35 Congress St
Ste 2
Salem, MA 01970
Phone (781) 745-2440

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1538808506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 CONGRESS ST BUILDING 2 REAR",
            "address_2": "UNIT 2150B",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "01970",
            "telephone_number": "781-745-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 CONGRESS ST BUILDING 2 REAR",
            "address_2": "UNIT 2150B",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "01970",
            "telephone_number": "781-745-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

Verify at the official NPI Registry.