Individual provider Active NPI

Samantha Patricia Peterkin, LMSW

  • School Social Worker
  • White Plains, NY
National Provider Identifier
1447405238
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
0704407-1 Issued in NY
Practice address
176 Gibson Ave
White Plains, NY 10607-2049
Phone
(914) 964-5496
Fax
(914) 423-6128
NPI assigned
Nov 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X 0704407-1 NY Primary

Addresses

Primary practice location

176 Gibson Ave
White Plains, NY 10607-2049

Mailing address

176 Gibson Ave
White Plains, NY 10607-2049
Phone (917) 202-1694

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
0704407-1NYMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1227225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1447405238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 GIBSON AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106072049",
            "telephone_number": "917-202-1694",
            "fax_number": "914-423-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 GIBSON AVE",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106072049",
            "telephone_number": "914-964-5496",
            "fax_number": "914-423-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERKIN",
        "first_name": "SAMANTHA",
        "middle_name": "PATRICIA",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-21",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NY",
            "license": "0704407-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.