Individual provider Active NPI

Samson Maher Laub, LCSW

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1356613442
Registry record updated Dec 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
082249 Issued in NY
Practice address
25 E 183Rd St
Bronx, NY 10453-1242
Phone
(718) 839-8900
Fax
(718) 563-8346
NPI assigned
Feb 3, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2016

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 082249 NY Primary

Addresses

Primary practice location

25 E 183Rd St
Bronx, NY 10453-1242

Mailing address

25 E 183Rd St
Bronx, NY 10453-1242
Phone (718) 839-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20150521001574 NY Practitioner - Clinical Social Worker 0840510426 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
082249NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
William F Ryan Community Health Center Inc CurrentSince Jul 31, 2017 Accepting new patients
William F Ryan Community Health Center Inc CurrentSince Jul 31, 2017 Accepting new patients

Locations

110 W 97th St
#0
New York, NY 10025

110 W 97th St
New York, NY 10025
Phone (212) 316-7906

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481846400000",
    "number": "1356613442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 E 183RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104531242",
            "telephone_number": "718-839-8900",
            "fax_number": "718-563-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E 183RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104531242",
            "telephone_number": "718-839-8900",
            "fax_number": "718-563-8346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUB",
        "first_name": "SAMSON",
        "middle_name": "MAHER",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-03",
        "last_updated": "2016-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.