Samantha Soufrine, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

4481 Issued in CT

Practice address

605 Washington Ave
North Haven, CT 06473-1123

Phone

(203) 214-1399

NPI assigned

Jul 9, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

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, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Lighthouse Counseling and Intervention LLC

  • Mental Health Counselor
  • North Haven, CT
  • NPI 1285273094
  Medicare reassignment NPD

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1962020685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 WASHINGTON AVE",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064731123",
            "telephone_number": "203-214-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 WASHINGTON AVE",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064731123",
            "telephone_number": "203-214-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUFRINE",
        "first_name": "SAMANTHA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CT",
            "license": "4481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC",
            "identifier": "4481",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie J Slattery, M.D.
• Joan S. Sloan, LCSW
• Nathan Lorenzo Smith, LCSW
• Allison Snelling
• Sos Path to Success LLC
• Soundview Counseling LLC
• Khristine A Sparta, DPM
• Shari L Specland
• SPH North Haven LLC
• Adriana Spino, APRN

• Counselor in North Haven, CT
• Providers in North Haven, CT by specialty
• Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.