Samantha Kissig

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

34950 Chardon Rd Ste 210
Willoughby Hills, OH 44094-9162

Phone

(216) 505-9536

NPI assigned

Jun 6, 2016

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 OH

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

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crossroads HealthGroup PAC ID 9638440241, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samantha.kissig.p1@direct.crh.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Crossroads Health

  • Adolescent and Children Mental Health Clinic/Center
  • Mentor, OH
  • NPI 1356303911
  Medicare reassignment Care Compare group NPD
• JNR Behavioral Therapy & Mediation Services

  • Mental Health Counselor
  • Willoughby Hills, OH
  • NPI 1033629340
  Medicare reassignment NPD
• Crossroads Health

  • Federally Qualified Health Center (FQHC)
  • Mentor, OH
  • NPI 1093307654
  NPD

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1558710087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34950 CHARDON RD STE 210",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440949162",
            "telephone_number": "440-596-9862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34950 CHARDON RD STE 210",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440949162",
            "telephone_number": "216-505-9536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSIG",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2102575-SUPV",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gazelle Kerr
• Keystone Rehabilitation Systems Inc
• Elizabeth Kightlinger
• Jamica King
• Mia Isabella King
• Ashley Michelle Knight
• Brian Andrew Koludrovich, DPM
• Michael Paul Koniarczyk, M.D.
• Brandon George Kopfstein, DPT
• Matthew Gerard Kramer

• Counselor in Willoughby Hills, OH
• Providers in Willoughby Hills, OH by specialty
• Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; 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.