Individual provider Active NPI

Samuel Barnard King Jr., STUDENT MSW/MPH

  • Clinical Social Worker
  • Elizabeth, NJ
National Provider Identifier
1295418697
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
655 Westfield Ave
Elizabeth, NJ 07208-1325
Phone
(908) 352-8375
Fax
(908) 352-8858
NPI assigned
Aug 11, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NJ Primary

Addresses

Primary practice location

655 Westfield Ave
Elizabeth, NJ 07208-1325

Mailing address

655 Westfield Ave
Elizabeth, NJ 07208-1325
Phone (908) 352-8375

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

NPI Registry JSON

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

{
    "created_epoch": "1691712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1295418697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 WESTFIELD AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081325",
            "telephone_number": "908-352-8375",
            "fax_number": "908-352-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 WESTFIELD AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081325",
            "telephone_number": "908-352-8375",
            "fax_number": "908-352-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "SAMUEL",
        "middle_name": "BARNARD",
        "name_suffix": "Jr.",
        "credential": "STUDENT MSW/MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-11",
        "last_updated": "2025-09-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.