Active NPI
Samantha Coley, MA, LCHMC, LPC
- Mental Health Counselor
- Salem, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C7274
- Practice address
- 2355 State St Ste 101
Salem, OR 97301-4541 - Phone
- (503) 967-5654
- NPI assigned
- Jul 31, 2019
- Last updated
- Jun 21, 2023
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV, OR, NC, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 4
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2728 | WV | MD | Emergency Medicine Physician |
| 14908 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Talkspace Provider Network PA | Current | Accepting new patients | |
| Mindful Therapy Group PC | Mental Health | Current | Accepting new patients |
| Talkspace Provider Network Ca PC | Current | 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.
-
dba Mindful Therapy Group
- Clinical Social Worker
- Mountlake Terrace, WA
- NPI 1316238678
Mental Health, OR
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- New York, NY
- NPI 1639814049
NC, OR, WV
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- New York, NY
- NPI 1003506866
CA
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.