Individual provider Active NPI

Samantha Espinosa, LCSW

  • Clinical Social Worker
  • Tallahassee, FL
National Provider Identifier
1386092302
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15644 Issued in FL
Practice address
2507 Callaway Rd
Tallahassee, FL 32303-5267
Phone
(850) 644-6543
NPI assigned
May 31, 2016
Last updated
Mar 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 15644 FL
Clinical Social Worker 1041C0700X 15644 FL Primary

Addresses

Primary practice location

2507 Callaway Rd
Tallahassee, FL 32303-5267

Mailing address

2507 Callaway Rd
Tallahassee, FL 32303-5267
Phone (850) 644-6543

Other practice location 1

2711 W 15th St
Panama City, FL 32401-1366
Phone (850) 769-6001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20181221002242 FL Practitioner - Clinical Social Worker 8224373063 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15644FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Therapy Services, Inc CurrentSince Jul 17, 2021 Accepting new patients
Apalachee Center, Inc. CurrentSince Nov 3, 2023 Accepting new patients
Apalachee Center Inc CurrentSince Nov 3, 2023 Accepting new patients
Florida Medical Practice Plan Inc Past Accepting new patients

Locations

6425 Pensacola Blvd
#13
Pensacola, FL 32505
Phone (850) 471-0017

2507 Callaway Rd
Ste 101
Tallahassee, FL 32303
Phone (850) 644-6543

2634 Capital Cir NE
Bldg J
Tallahassee, FL 32308
Phone (850) 523-3243

Interoperability endpoints

  • Direct secure messaging: samantha.espinosa.1@19268.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1386092302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2507 CALLAWAY RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323035267",
            "telephone_number": "850-644-6543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2507 CALLAWAY RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323035267",
            "telephone_number": "850-644-6543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2711 W 15th St",
            "address_purpose": "LOCATION",
            "city": "Panama City",
            "state": "FL",
            "postal_code": "324011366",
            "country_code": "US",
            "telephone_number": "850-769-6001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESPINOSA",
        "first_name": "SAMANTHA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-31",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "15644",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "15644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.