Individual provider Active NPI

Samantha J Kling, LMSW, CAADC

  • Clinical Social Worker
  • Benton Harbor, MI
National Provider Identifier
1477088870
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801106396 Issued in MI
Practice address
1485 M 139
Benton Harbor, MI 49022-5711
Phone
(269) 925-0585
Fax
(269) 927-1326
NPI assigned
Apr 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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
Clinical Social Worker 1041C0700X 6801106396 MI Primary

Addresses

Primary practice location

1485 M 139
Benton Harbor, MI 49022-5711

Mailing address

1485 M 139
Benton Harbor, MI 49022-5711
Phone (269) 925-0585

Other names 1

  • Samantha Fialko Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20200305002280 MI Practitioner - Clinical Social Worker 5496182362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Berrien Mental Health AuthorityGroup PAC ID 0345223707, 20 clinicians

Practice addresses (Care Compare)

1485 M
Suite 139
Benton Harbor, MI 49022-5711
Phone (269) 934-1611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Berrien Mental Health Authority Social Worker CurrentSince Jan 22, 2020 Accepting new patients
Berrien Mental Health Authority CurrentSince Jan 22, 2020 Accepting new patients

Locations

1485 M 139
Benton Harbor, MI 49022
Phone (269) 934-1611

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": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1477088870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 M 139",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490225711",
            "telephone_number": "269-925-0585",
            "fax_number": "269-927-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 M 139",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490225711",
            "telephone_number": "269-925-0585",
            "fax_number": "269-927-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLING",
        "first_name": "SAMANTHA",
        "middle_name": "J",
        "credential": "LMSW, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-24",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801106396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "FIALKO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Benton Harbor, MI

Sources for this page

Verify at the official NPI Registry.