Individual provider Active NPI

Samantha Stayton, LCSW, LSCSW

  • Clinical Social Worker
  • Kansas City, MO
National Provider Identifier
1124741384
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2021031853 Issued in MO
Practice address
6155 Oak St Ste C
Kansas City, MO 64113-2266
Phone
(816) 226-6802
NPI assigned
Sep 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 05582 KS
Clinical Social Worker 1041C0700X 2021031853 MO Primary

Addresses

Primary practice location

6155 Oak St Ste C
Kansas City, MO 64113-2266

Mailing address

904 E 39TH St Apt 1D
Kansas City, MO 64109-2692
Phone (816) 830-0268

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
05582KSMDClinical Social Worker
2021031853MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1124741384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 E 39TH ST APT 1D",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641092692",
            "telephone_number": "816-830-0268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6155 OAK ST STE C",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641132266",
            "telephone_number": "816-226-6802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAYTON",
        "first_name": "SAMANTHA",
        "credential": "LCSW, LSCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "05582",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2021031853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.