Samantha Lei Clark, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P016966 Issued in NC

Practice address

206 Carolina Ave
Grover, NC 28073-9551

Phone

(704) 476-8351

Fax

(704) 297-4646

NPI assigned

Oct 17, 2022

Last updated

Nov 3, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Gaston Family Health Services, Inc

  dba Kintegra at Grover Elementary

  • Federally Qualified Health Center (FQHC)
  • Grover, NC
  • NPI 1508681750
  NPD

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1336865708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-703-7003",
            "fax_number": "704-865-4614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 CAROLINA AVE",
            "city": "GROVER",
            "state": "NC",
            "postal_code": "280739551",
            "telephone_number": "704-476-8351",
            "fax_number": "704-297-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SAMANTHA",
        "middle_name": "LEI",
        "name_prefix": "Mrs.",
        "credential": "LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-17",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P016966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A Brighter Path LLC
• Julee Mae Anderson, LCMHCA
• Elizabeth Naomi Burns
• Central Transport Services of Cleveland County, Inc
• Century Care of Shelby
• Cleveland Health Ventures, LLC (Grover Family Practice)
• Empowered Housing Inc
• Caroline Belle England
• Gaston Family Health Services, Inc (Kintegra at Grover Elementary)
• Gaston Transportation Services LLC

• Clinical Social Worker in Grover, NC
• Providers in Grover, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.