Samantha Kristine Traum, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.026267 Issued in NU

Practice address

306 Wolf Den Cir
Davis Junction, IL 61020-9428

Phone

(815) 217-6607

NPI assigned

Apr 2, 2024

Last updated

Apr 4, 2024By the provider in NPPES

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

Enrolled in IL

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

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Beacon Pathways, PLLCGroup PAC ID 5395233837, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Beacon Pathways, PLLC

  • Clinical Social Worker
  • Davis Junction, IL
  • NPI 1770457558
  Medicare reassignment Care Compare group NPD Authorized official
• Blue Moon Senior Counseling of Illinois LLC

  • Clinical Social Worker
  • Plainfield, IL
  • NPI 1841562931
  Medicare reassignment NPD

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

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1316799505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 WOLF DEN CIR",
            "city": "DAVIS JUNCTION",
            "state": "IL",
            "postal_code": "610209428",
            "telephone_number": "815-217-6607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 WOLF DEN CIR",
            "city": "DAVIS JUNCTION",
            "state": "IL",
            "postal_code": "610209428",
            "telephone_number": "815-217-6607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAUM",
        "first_name": "SAMANTHA",
        "middle_name": "KRISTINE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-02",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": "149.026267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sergio Martinez, RN
• Mobile Imaging Solutions, Inc.
• Daniel R Retzer, MD
• Margret M. Saint Louis, APN
• Swedishamerican Hospital
• Brittney Wyatt

• Clinical Social Worker in Davis Junction, IL
• Providers in Davis Junction, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.