Individual provider Active NPI

Samantha Kaylee Metoyer, LCPC

  • Professional Counselor
  • South Barrington, IL
National Provider Identifier
1871934786
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180015189 Issued in IL
Practice address
33 W Higgins Rd Ste 2030
South Barrington, IL 60010-9342
Phone
(847) 844-0864
NPI assigned
Jul 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178014543 IL
Professional Counselor 101YP2500X 180015189 IL Primary

Addresses

Primary practice location

33 W Higgins Rd Ste 2030
South Barrington, IL 60010-9342

Mailing address

20 Marilyn Cir
Fairview Heights, IL 62208-2839
Phone (224) 204-7878

Other practice location 1

3700 S Wallace St
Chicago, IL 60609-1745
Phone (312) 448-8213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20240808002617 IL Practitioner - Mental Health Counselor 2668919572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maloy Therapeutic Alliance IncGroup PAC ID 7416284740, 5 clinicians

Practice addresses (Care Compare)

33 W Higgins Rd
Suite 2030
South Barrington, IL 60010-9342
Phone (847) 844-0864

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178014543ILMDProfessional Counselor
180015189ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Maloy Therapeutic Alliance Inc CurrentSince Jun 1, 2024 Accepting new patients
DM Speech Therapy LLC PastSince Jun 1, 2024 Accepting new patients
Safe Place Counseling Past Accepting new patients

Locations

33 W Higgins Rd
Ste 2030
South Barrington, IL 60010
Phone (224) 628-5823

Interoperability endpoints

  • Direct secure messaging: samantha.horton.p1@direct.gefcc.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1871934786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MARILYN CIR",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082839",
            "telephone_number": "224-204-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W HIGGINS RD STE 2030",
            "city": "SOUTH BARRINGTON",
            "state": "IL",
            "postal_code": "600109342",
            "telephone_number": "847-844-0864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3700 S Wallace St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606091745",
            "country_code": "US",
            "telephone_number": "312-448-8213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "METOYER",
        "first_name": "SAMANTHA",
        "middle_name": "KAYLEE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-09",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178014543",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180015189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Barrington, IL

Sources for this page

Verify at the official NPI Registry.