Individual provider Active NPI

Samantha Jo Brannen, MSW, PHD

  • Clinical Social Worker
  • Wood Heights, MO
National Provider Identifier
1043353089
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2002026474 Issued in MO
Practice address
449 Wyman Dr
Wood Heights, MO 64024-2803
Phone
(816) 317-4120
Fax
(816) 479-2203
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 4

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20050308001147 MO Practitioner - Clinical Social Worker 7618928045 Reassigns benefits to 1 organization
Practice locations: Kansas City, MO

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients
Tri-County Psychological Services, Inc. PastSince Apr 29, 2015 Accepting new patients
Cobblestone Specialty Care Inc Past Accepting new patients
Tri-County Adult Day Care Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2002026474 MO Primary

Addresses

NPPES NPI Registry

Primary practice location

449 Wyman Dr
Wood Heights, MO 64024-2803

Mailing address

449 Wyman Dr
Wood Heights, MO 64024-2803
Phone (816) 317-4120

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
498318716MedicaidMO

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 27, 2026.

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1043353089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 WYMAN DR",
            "city": "WOOD HEIGHTS",
            "state": "MO",
            "postal_code": "640242803",
            "telephone_number": "816-317-4120",
            "fax_number": "816-479-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 WYMAN DR",
            "city": "WOOD HEIGHTS",
            "state": "MO",
            "postal_code": "640242803",
            "telephone_number": "816-317-4120",
            "fax_number": "816-479-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNEN",
        "first_name": "SAMANTHA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "MSW, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2002026474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "498318716",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wood Heights, MO

Sources for this page

Verify at the official NPI Registry.