Individual provider Active NPI

Alexandra Theo Samets, LCSW-C

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1265862429
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22278 Issued in MD
Practice address
The Baltimore Center for Psychotherapy
623 West 34TH Street #105
Baltimore, MD 21211
Phone
(443) 475-0304
NPI assigned
Nov 25, 2013
Last updated
Feb 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 22278 MD Primary

Addresses

Primary practice location

The Baltimore Center for Psychotherapy
623 West 34TH Street #105
Baltimore, MD 21211

Mailing address

The Baltimore Center for Psychotherapy
623 West 34TH Street #105
Baltimore, MD 21211
Phone (443) 475-0304

Other practice location 1

140 High St
Greenfield, MA 01301-2702
Phone (413) 772-0249

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

LicenseStateTypeSpecialty
22278MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1385337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1265862429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "THE BALTIMORE CENTER FOR PSYCHOTHERAPY",
            "address_2": "623 WEST 34TH STREET #105",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21211",
            "telephone_number": "443-475-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THE BALTIMORE CENTER FOR PSYCHOTHERAPY",
            "address_2": "623 WEST 34TH STREET #105",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21211",
            "telephone_number": "443-475-0304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 High St",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "MA",
            "postal_code": "013012702",
            "country_code": "US",
            "telephone_number": "413-772-0249",
            "fax_number": "413-774-1785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMETS",
        "first_name": "ALEXANDRA",
        "middle_name": "THEO",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-25",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "22278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.