Samantha Lynn Crumb, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801104620 Issued in MI

Practice address

801 Hazen St
Paw Paw, MI 49079-2008

Phone

(269) 657-5574

NPI assigned

May 30, 2019

Last updated

Dec 5, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Van Buren Community Mental Health AuthorityGroup PAC ID 6800863788, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Van Buren Community Mental Health Authority

  • Psychiatry Physician
  • Paw Paw, MI
  • NPI 1003878554
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1194383794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69201 66TH AVE",
            "city": "WATERVLIET",
            "state": "MI",
            "postal_code": "490989412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 HAZEN ST",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490792008",
            "telephone_number": "269-657-5574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUMB",
        "first_name": "SAMANTHA",
        "middle_name": "LYNN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2022-12-05",
        "certification_date": "2021-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801104620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Cooper, FNP-C
• Taylor Cornelius
• Paul Stephen Costanzo, PA-C
• Elizabeth Courtney
• Stephanie Joan Croy, DO
• Bradley Kent Dagen Jr., PHARMD
• Madison Rae Dalimonte
• Linda Heather Davis, BS, LBSW
• Noal Wayne Davis
• William Stanton Davis, PMHNP-BC

• Clinical Social Worker in Paw Paw, MI
• Providers in Paw Paw, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.