Individual provider Active NPI

Samantha Ann Mishne, MSW, LISW-S

  • Clinical Social Worker
  • Shaker Heights, OH
National Provider Identifier
1124061395
Registry record updated Jan 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-0009299 Issued in OH
Practice address
19910 Malvern Rd Ste 217
Shaker Heights, OH 44122-2823
Phone
(216) 513-0192
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-0009299 OH Primary

Addresses

Primary practice location

19910 Malvern Rd Ste 217
Shaker Heights, OH 44122-2823

Mailing address

19910 Malvern Rd Ste 217
Shaker Heights, OH 44122-2823
Phone (216) 513-0192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-0009299OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767225600000",
    "number": "1124061395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19910 MALVERN RD STE 217",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441222823",
            "telephone_number": "216-513-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19910 MALVERN RD STE 217",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441222823",
            "telephone_number": "216-513-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHNE",
        "first_name": "SAMANTHA",
        "middle_name": "ANN",
        "credential": "MSW, LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2026-01-01",
        "certification_date": "2026-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-0009299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shaker Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2026; 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.