Samantha Dawn Weaver

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

15 4TH St
Malone, NY 12953-1340

Phone

(518) 481-8160

NPI assigned

Jan 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Behavioral Health Services North, Inc.Group PAC ID 3173511557, 68 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Behavioral Health Services North, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Morrisonville, NY
  • NPI 1689621468
  Medicare reassignment Care Compare group NPD
• Behavioral Health Services North, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Queensbury, NY
  • NPI 1447005541
  NPD
• Citizen Advocates, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Malone, NY
  • NPI 1780619064
  NPD (past)
• Franklin County Community Services

  • Local Education Agency (LEA)
  • Saranac Lake, NY
  • NPI 1740334671
  NPD (past)

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1952991754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 SEYMOUR RD",
            "city": "WEST CHAZY",
            "state": "NY",
            "postal_code": "129922324",
            "telephone_number": "518-534-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 4TH ST",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129531340",
            "telephone_number": "518-481-8160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Edgewood Rd",
            "address_purpose": "LOCATION",
            "city": "Saranac Lake",
            "state": "NY",
            "postal_code": "129831537",
            "country_code": "US",
            "telephone_number": "518-891-5535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "SAMANTHA",
        "middle_name": "DAWN",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Eileen Walczak, RN
• Walgreen Co
• Walgreen Co
• Angela May Warner
• Kaitlynne Warner
• Laura Marble Weber
• Ira M Weissman, MD
• Allie Elizabeth Wells, PT, DPT
• Catherine Stewart Werley, R.N.
• Joan Westcott

• Mental Health Counselor in Malone, NY
• Providers in Malone, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.