Individual provider Active NPI

Samantha Cobert Bothast, LCSW

  • Clinical Social Worker
  • Encino, CA
National Provider Identifier
1437644051
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
19821 Issued in CA
Practice address
16055 Ventura Blvd Ste 635
Encino, CA 91436-2609
Phone
(818) 456-6421
NPI assigned
Jun 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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 19821 CA Primary

Addresses

Primary practice location

16055 Ventura Blvd Ste 635
Encino, CA 91436-2609

Mailing address

16055 Ventura Blvd Ste 635
Encino, CA 91436-2609
Phone (818) 456-6421

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
19821CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1437644051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16055 VENTURA BLVD STE 635",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362609",
            "telephone_number": "818-456-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16055 VENTURA BLVD STE 635",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362609",
            "telephone_number": "818-456-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTHAST",
        "first_name": "SAMANTHA",
        "middle_name": "COBERT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "19821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.