Samara Benenson Roth, LICSW, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC50082900 Issued in DC

Practice address

2333 Ontario Rd NW
Washington, DC 20009-2627

Phone

(202) 819-4537

NPI assigned

Nov 11, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1573430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1366087637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 ONTARIO RD NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200092627",
            "telephone_number": "202-420-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 ONTARIO RD NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200092627",
            "telephone_number": "202-819-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "SAMARA",
        "middle_name": "BENENSON",
        "credential": "LICSW, LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-11",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "104516-1",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "24176",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50082900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Roster, MD
• Joseph Lee Roswarski, M.D.
• Stephen A Roszel, LGSW
• Katalin Eve Roth, M.D.
• Rebecca Roth
• Paige Anderson Rothblum, DPT
• Susanne Rothe
• Kelly Rothermel
• Carla Rothgery, NP
• David Rothkopf, D.D.S.

• Clinical Social Worker in Washington, DC
• Providers in Washington, DC by specialty
• Clinical Social Worker in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.