Samantha Mae Fenno, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149016820 Issued in IL

Practice address

25 E Washington St Ste 1717
Chicago, IL 60602-1839

Phone

(410) 493-6028

NPI assigned

Aug 21, 2014

Last updated

Sep 2, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567382400000",
    "number": "1053710509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 E WASHINGTON ST STE 1717",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021839",
            "telephone_number": "410-493-6028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E WASHINGTON ST STE 1717",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021839",
            "telephone_number": "410-493-6028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNO",
        "first_name": "SAMANTHA",
        "middle_name": "MAE",
        "name_prefix": "Prof.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2019-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149016820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason G Fennema, D.C.
• Lariza Fenner-Lux
• Anna Fenner, MD
• Soreida Mamie Fennerr
• Michelle Margaret Fennessy, CNS, APN
• James Steven Fenoglio, MD
• Erika Mary Fenstad
• Craig A Fenton, M.D.
• Emily Fenton
• Gregory Fenton, M.D.

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.