Individual provider Active NPI

Samantha Brooke Rose, LCSW

  • Clinical Social Worker
  • Naperville, IL
National Provider Identifier
1013326719
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2948 Artesian Rd Ste 112
Naperville, IL 60564-8559
Phone
(630) 428-7890
NPI assigned
Aug 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2014023629 MO
Clinical Social Worker 1041C0700X Primary
Social Worker 104100000X 150.102587 IL
Clinical Social Worker 1041C0700X 149022439 IL

Addresses

Primary practice location

2948 Artesian Rd Ste 112
Naperville, IL 60564-8559

Mailing address

2948 Artesian Rd Ste 112
Naperville, IL 60564-8559
Phone (630) 428-7890

Other names 1

  • Samantha Brooke Payton Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, IL2 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

Enrollment IDStateProvider typePAC IDDetails
I20220818001739 KS Practitioner - Clinical Social Worker 2769865005 Reassigns benefits to 1 organization
I20230908001230 IL Practitioner - Clinical Social Worker 2769865005 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150.102587ILMDSocial Worker
2014023629MOMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Edgewood Clinical Services, P.C. Clinical CurrentSince Aug 7, 2023 Accepting new patients
Samantha Rose Counseling Clinical Current Accepting new patients
Soma Recovery LLC CurrentSince Aug 4, 2022 Accepting new patients
Psychology Specialists LTD Clinical Past Accepting new patients
Edgewood Clinical Services, P.C. PastSince Aug 7, 2023 Accepting new patients

Locations

808 S Eldorado Rd
Ste 102
Bloomington, IL 61704
Phone (309) 212-6007

3027 English Rows Ave
Ste 201
Naperville, IL 60564

2948 Artesian Rd
Ste 112
Naperville, IL 60564
Phone (630) 328-0165

2544 N Maize Ct
Ste 100
Wichita, KS 67205
Phone (316) 201-6047

3219 E Douglas Ave
Wichita, KS 67218
Phone (316) 201-6047

825 N Waco Ave
Wichita, KS 67203
Phone (316) 201-6047

Networks

  • IL PPO Downstate
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • IL HMO C-SNP

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.samantharose@146897.advancedmd-direct.com

Organizations & group practices 5

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": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1013326719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2948 ARTESIAN RD STE 112",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648559",
            "telephone_number": "630-428-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2948 ARTESIAN RD STE 112",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648559",
            "telephone_number": "630-428-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "SAMANTHA",
        "middle_name": "BROOKE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-06",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2014023629",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.102587",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149022439",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "PAYTON",
            "middle_name": "BROOKE",
            "credential": "LSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.