Samantha R Tatum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW99259 Issued in CA

Practice address

419 Webster St Ste 202
Monterey, CA 93940-3241

Phone

(408) 600-0089

Fax

(510) 756-0812

NPI assigned

Mar 24, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Open Mind Mental Health Physicians, Inc.

  dba Open Mind Health

  • Clinical Social Worker
  • La Jolla, CA
  • NPI 1093454423

  Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1447837737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1189 TRINITY AVE",
            "city": "SEASIDE",
            "state": "CA",
            "postal_code": "939555322",
            "telephone_number": "831-224-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 WEBSTER ST STE 202",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939403241",
            "telephone_number": "408-600-0089",
            "fax_number": "510-756-0812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1189 Trinity Ave",
            "address_purpose": "LOCATION",
            "city": "Seaside",
            "state": "CA",
            "postal_code": "939555322",
            "country_code": "US",
            "telephone_number": "831-224-0645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TATUM",
        "first_name": "SAMANTHA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LCSW99259",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW99259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brigitta Tanzer, FNP-C
• Geraldine C Taplin, M.D
• Tiffany Diane Tarasoff IX
• Barbara Pauline Tardy
• Jeffrey P Tarola, D.D.S.
• Cheri Lynne Taylor, AU.D.
• Lisa Taylor
• Terri Maria Taylor, RBT
• Sade Teel
• Dorothy Tenney

• Clinical Social Worker in Monterey, CA
• Providers in Monterey, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.