Samantha Monika Mitra, MA, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

8041 Issued in MN

Practice address

1155 Northland Dr
Mendota Heights, MN 55120-1288

Phone

(612) 223-8898

NPI assigned

Oct 13, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, WI2 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 2

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Optum Behavioral Care of Colorado PCGroup PAC ID 0941648463, 196 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Optum Behavioral Care of Colorado, P.C.

  • Clinical Psychologist
  • Baxter, MN
  • NPI 1124898556
  Medicare reassignment Care Compare group NPD
• Calming Currents Mental Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Hudson, WI
  • NPI 1407617301
  Medicare reassignment
• Care Clinics, LLC

  • Psychologist
  • St Louis Park, MN
  • NPI 1851716245
  NPD
• Optum Behavioral Care of Colorado, P.C.

  • Clinical Social Worker
  • De Pere, WI
  • NPI 1396622494
  NPD
• Optum Behavioral Care of Colorado PC

  • Psychologist
  • Edina, MN
  • NPI 1336967561
  NPD (past)

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1871255182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 NORTHLAND DR",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201288",
            "telephone_number": "612-223-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 NORTHLAND DR",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201288",
            "telephone_number": "612-223-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITRA",
        "first_name": "SAMANTHA",
        "middle_name": "MONIKA",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-13",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "8041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Marie Mesenbrink
• Aubrey Miller, LPCC
• Gregory Aaron Miller
• Martha Miller
• Dove Mitchell
• Abdinasir Hassan Mohamed
• Amal Mohamed
• Fatima Mohamud Mohamed
• Horseed Abdisalam Mohamed
• Huda Siad Mohamed

• Professional Counselor in Mendota Heights, MN
• Providers in Mendota Heights, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.

Verify at the official NPI Registry.