Individual provider Active NPI

Samantha Stambach, LICSW

  • Clinical Social Worker
  • Warwick, RI
National Provider Identifier
1336770353
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW03054 Issued in RI
Practice address
2756 Post Rd
Warwick, RI 02886-3003
Phone
(401) 691-6000
Fax
(401) 691-3398
NPI assigned
Jan 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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 ISW03054 RI Primary

Addresses

Primary practice location

2756 Post Rd
Warwick, RI 02886-3003

Mailing address

2756 Post Rd
Warwick, RI 02886-3003
Phone (401) 691-6000

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
ISW03054RIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1336770353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2756 POST RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028863003",
            "telephone_number": "401-691-6000",
            "fax_number": "401-691-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2756 POST RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028863003",
            "telephone_number": "401-691-6000",
            "fax_number": "401-691-3398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMBACH",
        "first_name": "SAMANTHA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW03054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; 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.