Individual provider Active NPI

Christina Marie Samyan, MSW, LCSW

  • Clinical Social Worker
  • Media, PA
National Provider Identifier
1467523845
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW015603 Issued in PA
Practice address
210 W Front St
2CD FL, Suite 3
Media, PA 19063-3101
Phone
(610) 565-6067
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 CW015603 PA Primary

Addresses

Primary practice location

210 W Front St
2CD FL, Suite 3
Media, PA 19063-3101

Mailing address

212 Rockford Rd
Boothwyn, PA 19061-2446
Phone (610) 457-6822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20130819000095 PA Practitioner - Clinical Social Worker 1557503711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctor on Demand Professionals P CGroup PAC ID 9436464567, 113 clinicians

Practice addresses (Care Compare)

2595 Interstate Dr
Suite 103
Harrisburg, PA 17110-9378
Phone (800) 997-6196

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW015603PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Doctor on Demand Professionals P C CurrentSince Oct 13, 2021 Accepting new patients
Springfield Psychological PC CurrentSince Jul 3, 2017 Accepting new patients

Locations

1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926

2595 Interstate Dr
Ste 103
Harrisburg, PA 17110
Phone (386) 672-4222

1489 Baltimore Pike
Ste 250
Springfield, PA 19064
Phone 6105442110144

Interoperability endpoints

  • Direct secure messaging: christina.samyan.1@30520.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467523845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 ROCKFORD RD",
            "city": "BOOTHWYN",
            "state": "PA",
            "postal_code": "190612446",
            "telephone_number": "610-457-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W FRONT ST",
            "address_2": "2CD FL, SUITE 3",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190633101",
            "telephone_number": "610-565-6067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMYAN",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW015603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.