Samantha Denise Slagle, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5290 Issued in TN

Practice address

26 Midway St
Bristol, TN 37620-1706

Phone

(423) 989-4500

Fax

(423) 989-4582

NPI assigned

Mar 30, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Samantha Matney Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1093835183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 SPRATLIN PARK DR",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376156205",
            "telephone_number": "423-467-3600",
            "fax_number": "423-467-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 MIDWAY ST",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201706",
            "telephone_number": "423-989-4500",
            "fax_number": "423-989-4582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLAGLE",
        "first_name": "SAMANTHA",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "TN",
            "license": "5290",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "5290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "MATNEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samuel Sim, MD
• Kelly Carter Simcox, FNP-BC
• Evelyn Faye Simerly, REGISTERED NURSE
• Mara W Sindoni, MA
• Brittney Kestner Skeen
• Laura Slaughter
• Jon Slaven, PA-C
• Barbara Jo Smith, FNP
• Bridges Wade Smith III, MS, LSPE
• Cameron Quincy Smith, M.D.

• Clinical Social Worker in Bristol, TN
• Providers in Bristol, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.