Tamara Ann Samuels, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C012184 Issued in NC

Practice address

1914 Brunswick Ave Ste 1B
Charlotte, NC 28207-1891

Phone

(704) 910-2055

NPI assigned

Aug 30, 2018

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Renewed Peace PLLC

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1528862760
  NPD Authorized official

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1073095741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2329 MONTICELLO DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280566563",
            "telephone_number": "704-724-6206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1914 BRUNSWICK AVE STE 1B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071891",
            "telephone_number": "704-910-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "TAMARA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C012184",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shernette Samuels-Bremnor
• Charles Hayward Samuels Jr., CSAC-21775
• Darnita Denise Samuels, MSA, MA, LMFTA
• Natalie Samuels
• Seima Samuels, MSW, LCSW
• Kristen Lahm Samuelson, PA
• Virginia Catherine Sances, LCMHCA
• Estefany Sanchez Mendez
• Gisela De la Caridad Sanchez Triana
• Alicia Sanchez

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.