Individual provider Active NPI

Samantha K Bryant, LCSW

  • Clinical Social Worker
  • Clermont, FL
National Provider Identifier
1255615142
Registry record updated Nov 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW12620 Issued in FL
Practice address
1601 Hooks St
Clermont, FL 34711-3510
Phone
(407) 953-8968
NPI assigned
Oct 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2019

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 ISW6902 FL
Clinical Social Worker 1041C0700X SW12620 FL Primary

Addresses

Primary practice location

1601 Hooks St
Clermont, FL 34711-3510

Mailing address

1726 Garden View St
Mascotte, FL 34753-9541
Phone (407) 953-8968

Other practice location 1

835 7th St Ste 4
Clermont, FL 34711-2190
Phone (407) 953-8968

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW6902FLMDClinical Social Worker
SW12620FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574035200000",
    "number": "1255615142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 GARDEN VIEW ST",
            "city": "MASCOTTE",
            "state": "FL",
            "postal_code": "347539541",
            "telephone_number": "407-953-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 HOOKS ST",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347113510",
            "telephone_number": "407-953-8968"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 7th St Ste 4",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "FL",
            "postal_code": "347112190",
            "country_code": "US",
            "telephone_number": "407-953-8968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "SAMANTHA",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-10",
        "last_updated": "2019-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW6902",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.