Active NPI
Samantha Miller
- Mental Health Counselor
- Rochester, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 401 16TH St SE Ste 100
Rochester, MN 55904-7974 - Phone
- (507) 516-0030
- Fax
- (507) 516-0031
- NPI assigned
- Aug 10, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
401 16TH St SE Ste 100
Rochester, MN 55904-7974
Mailing address
1900 Silver Lake Rd NW
New Brighton, MN 55112-1786
Phone (651) 628-9566
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240122002654 | MN | Practitioner - Mental Health Counselor | 8325490709 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1592 | MN | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nystrom & Associates, LTD | Current | Accepting new patients | |
| Family Support Services Inc. | Mental Health | Past | Accepting new patients |
Locations
1370 Mendota Heights Rd
Mendota Heights, MN 55120
Phone (651) 583-4447
401 16th St SE
Ste 100
Rochester, MN 55904
Phone (507) 516-0030
3425 40th Ave NW
Ste 101
Rochester, MN 55901
Phone (507) 398-3210
1150 Montreal Ave
Ste 107
Saint Paul, MN 55116
Phone (651) 303-8080
1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704
Organizations & group practices 2
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.
-
- Clinical Social Worker
- New Brighton, MN
- NPI 1396750188
-
- Mental Health Counselor
- New Brighton, MN
- NPI 1467549220
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541462400000",
"number": "1548785603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 SILVER LAKE RD NW",
"city": "NEW BRIGHTON",
"state": "MN",
"postal_code": "551121786",
"telephone_number": "651-628-9566",
"fax_number": "651-628-0411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 16TH ST SE STE 100",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559047974",
"telephone_number": "507-516-0030",
"fax_number": "507-516-0031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-10",
"last_updated": "2018-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.