Active NPI
Samantha B Coleman, MS, LPC, NCC
- Mental Health Counselor
- McComb, MS
National Provider Identifier
1790150969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1701 White Street
McComb, MS 39648 - Phone
- (601) 249-4217
- Fax
- (601) 249-4234
- NPI assigned
- Dec 14, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 5781 | LA | |
| Mental Health Counselor | 101YM0800X | LA | Primary |
Addresses
Primary practice location
1701 White Street
McComb, MS 39648
Mailing address
PO Box 768
1701 White Street
McComb, MS 39648
Phone (601) 249-4217
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5781 | LA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494460800000",
"number": "1790150969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 768",
"address_2": "1701 WHITE STREET",
"city": "MCCOMB",
"state": "MS",
"postal_code": "39648",
"telephone_number": "601-249-4217",
"fax_number": "601-249-4234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 WHITE STREET",
"city": "MCCOMB",
"state": "MS",
"postal_code": "39648",
"telephone_number": "601-249-4217",
"fax_number": "601-249-4234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "SAMANTHA",
"middle_name": "B",
"name_prefix": "Miss",
"credential": "MS, LPC, NCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-14",
"last_updated": "2017-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "LA",
"license": "5781",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "LA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McComb, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.