Active NPI
Samantha Kroot
- Mental Health Counselor
- Evanston, IL
National Provider Identifier
1891489035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 622 Davis St Ste 200
Evanston, IL 60201-4491 - Phone
- (773) 294-0176
- NPI assigned
- Jun 8, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
622 Davis St Ste 200
Evanston, IL 60201-4491
Mailing address
1122 N Dearborn St Apt 8E
Chicago, IL 60610-5061
Phone (317) 625-4378
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Polina Reyngold, LTD | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Professional Counselor
- Evanston, IL
- NPI 1649644071
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686182400000",
"number": "1891489035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1122 N DEARBORN ST APT 8E",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606105061",
"telephone_number": "317-625-4378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "622 DAVIS ST STE 200",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602014491",
"telephone_number": "773-294-0176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KROOT",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-08",
"last_updated": "2023-06-08",
"certification_date": "2023-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.