Individual provider Active NPI

Samantha Graham, LISW-CP; LICSW

  • Clinical Social Worker
  • Summerville, SC
National Provider Identifier
1245985951
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14923 Issued in SC
Practice address
103B Harth PL
Summerville, SC 29485-8107
Phone
(843) 879-3520
NPI assigned
Feb 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 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 61160458 WA
Clinical Social Worker 1041C0700X 14923 SC Primary

Addresses

Primary practice location

103B Harth PL
Summerville, SC 29485-8107

Mailing address

103B Harth PL
Summerville, SC 29485-8107
Phone (843) 879-3520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20220616000640 SC Practitioner - Clinical Social Worker 8628457918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Group practices
Compass Counseling LLCGroup PAC ID 3577893890, 7 clinicians

Practice addresses (Care Compare)

103 Harth PL
Suite B
Summerville, SC 29485-8107
Phone (843) 879-3520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14923SCMDClinical Social Worker
61160458WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Counseling, LLC Clinical CurrentSince Mar 18, 2022 Accepting new patients

Locations

103 Harth Pl
#B
Summerville, SC 29485
Phone (843) 879-3520

103B Harth Pl
Summerville, SC 29485
Phone (843) 619-2990

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1245985951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103B HARTH PL",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858107",
            "telephone_number": "843-879-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103B HARTH PL",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858107",
            "telephone_number": "843-879-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "SAMANTHA",
        "credential": "LISW-CP; LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-21",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "61160458",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "14923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.