Jacqueline Isonia Samuda, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10747 Issued in MD

Practice address

932 Hungerford Dr Ste 36B
Rockville, MD 20850-1753

Phone

(240) 461-1551

NPI assigned

Feb 16, 2007

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Aug 7, 2017 through Aug 7, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245374883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9073 PICKWICK VILLAGE TER",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209013882",
            "telephone_number": "301-439-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 HUNGERFORD DR STE 36B",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208501753",
            "telephone_number": "240-461-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUDA",
        "first_name": "JACQUELINE",
        "middle_name": "ISONIA",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "10747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelin Sampson
• Nia Sampson
• Shauntia Sampson
• Jessica G Samson, PSY.D.
• Porsche Samson
• Samuel K Huang, DDS
• Samuel S. Norvell, M.D.
• Olujumoke Samuel
• Jay H. Samuels, D.D.S.
• Nicole Samuels

• Clinical Social Worker in Rockville, MD
• Providers in Rockville, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.