Active NPI
Mimi Samter
- Clinical Social Worker
- Garden City, NY
National Provider Identifier
1225308703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 72062514
- Practice address
- 71 Clinton Road
Garden City, NY 11530 - Phone
- (516) 396-2255
- Fax
- (516) 396-2467
- NPI assigned
- Dec 30, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 72062514 | NY | Primary |
Addresses
Primary practice location
71 Clinton Road
Garden City, NY 11530
Mailing address
71 Clinton Road
Garden City, NY 11530
Phone (516) 396-2255
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
| License | State | Type | Specialty |
|---|---|---|---|
| 72062514 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325203200000",
"number": "1225308703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "71 CLINTON ROAD",
"city": "GARDEN CITY",
"state": "NY",
"postal_code": "11530",
"telephone_number": "516-396-2255",
"fax_number": "516-396-2467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71 CLINTON ROAD",
"city": "GARDEN CITY",
"state": "NY",
"postal_code": "11530",
"telephone_number": "516-396-2255",
"fax_number": "516-396-2467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMTER",
"first_name": "MIMI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-30",
"last_updated": "2011-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "72062514",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.