Individual provider Active NPI

Samantha Coley, MA, LCHMC, LPC

  • Mental Health Counselor
  • Salem, OR
National Provider Identifier
1619521325
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C7274 Issued in OR
Practice address
2355 State St Ste 101
Salem, OR 97301-4541
Phone
(503) 967-5654
NPI assigned
Jul 31, 2019
Last updated
Jun 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2728 WV
Mental Health Counselor 101YM0800X 14908 NC
Mental Health Counselor 101YM0800X C7274 OR Primary

Addresses

Primary practice location

2355 State St Ste 101
Salem, OR 97301-4541

Mailing address

2355 State St Ste 101
Salem, OR 97301-4541
Phone (503) 967-5654

Other names 1

  • Samantha Beckelhimer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OR, NC, CA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20240920001831 WV Practitioner - Mental Health Counselor 5092256743 Reassigns benefits to 1 organization
I20250226003665 OR Practitioner - Mental Health Counselor 5092256743 Reassigns benefits to 2 organizations
I20250806004493 NC Practitioner - Mental Health Counselor 5092256743 Reassigns benefits to 1 organization
I20260106002714 CA Practitioner - Mental Health Counselor 5092256743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians
Talkspace Provider Network PAGroup PAC ID 5799136701, 249 clinicians

Practice addresses (Care Compare)

11740 SW 68TH Pkwy
Suite 200
Tigard, OR 97223-9058
Phone (971) 352-6984

178 Mapleview Dr
Beckley, WV 25801-8727
Phone (336) 250-2191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2728WVMDEmergency Medicine Physician
14908NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Talkspace Provider Network PA CurrentSince Jul 5, 2024 Accepting new patients
Mindful Therapy Group PC Mental Health CurrentSince Feb 12, 2025 Accepting new patients
Talkspace Provider Network Ca PC CurrentSince Oct 23, 2025 Accepting new patients

Locations

2578 Broadway
#607
New York, NY 10025
Phone (516) 847-5432

2578 Broadway
Ste 607
New York, NY 10025
Phone (304) 308-3735

5440 SW Westgate Dr
Ste 350
Portland, OR 97221
Phone (503) 292-1100

11740 SW 68th Pkwy
Ste 200
Tigard, OR 97223
Phone (425) 477-4216

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

Organizations & group practices 3

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": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1619521325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 STATE ST STE 101",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014541",
            "telephone_number": "503-967-5654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 STATE ST STE 101",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014541",
            "telephone_number": "503-967-5654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEY",
        "first_name": "SAMANTHA",
        "credential": "MA, LCHMC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WV",
            "license": "2728",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "14908",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C7274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "BECKELHIMER",
            "credential": "MA, LCMHC, LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.