Individual provider Active NPI

Samantha Brown, PSYD

  • Clinical Psychologist
  • Orangeburg, NY
National Provider Identifier
1164049003
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
027339 Issued in NY
Practice address
140 Old Orangeburg Rd
Orangeburg, NY 10962-1157
Phone
(845) 359-1000
NPI assigned
Jun 26, 2020
Last updated
Jan 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 027339 NY Primary

Addresses

Primary practice location

140 Old Orangeburg Rd
Orangeburg, NY 10962-1157

Mailing address

140 Old Orangeburg Rd
Orangeburg, NY 10962-1157
Phone (845) 359-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260212003476 NY Order and Referring Only - Clinical Psychologist 8921588666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgewell, Inc PastSince Jun 1, 2020 Accepting new patients
Bridgewell Counseling Mental Health PastSince Jun 1, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1164049003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 OLD ORANGEBURG RD",
            "city": "ORANGEBURG",
            "state": "NY",
            "postal_code": "109621157",
            "telephone_number": "845-359-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 OLD ORANGEBURG RD",
            "city": "ORANGEBURG",
            "state": "NY",
            "postal_code": "109621157",
            "telephone_number": "845-359-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SAMANTHA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "027339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, NY

Sources for this page

Verify at the official NPI Registry.