Samantha Clark, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

DP00946604 Issued in WV

Practice address

120 Professional PL Ste 101
Bridgeport, WV 26330-4599

Phone

(304) 513-3495

Fax

(800) 734-8498

NPI assigned

Jan 7, 2022

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 WV

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

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grandw IncGroup PAC ID 9739324922, 93 clinicians

Practice addresses (Care Compare)

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.

• GR&W, Inc

  dba GR&W Harmony

  • Clinical Neuropsychologist
  • Morgantown, WV
  • NPI 1407192024
  Medicare reassignment Care Compare group NPD
• GR&W, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Morgantown, WV
  • NPI 1992665723
  NPD (past)
• Innersight LLC

  • Clinical Social Worker
  • Greensburg, PA
  • NPI 1265921357
  NPD (past)

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1477214898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 WHITE WILLOW WAY",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265056119",
            "telephone_number": "304-513-3495",
            "fax_number": "800-734-8498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PROFESSIONAL PL STE 101",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263304599",
            "telephone_number": "304-513-3495",
            "fax_number": "800-734-8498"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 E Grafton Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Fairmont",
            "state": "WV",
            "postal_code": "265544465",
            "country_code": "US",
            "telephone_number": "304-366-5832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SAMANTHA",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-07",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "DP00946604",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "138525",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David H Church, M.D.
• David A Ciarolla, MD
• Kathy Citerone, OTRL
• City of Bridgeport
• Jazzriel Le Clark-Casto, NP
• Clarksburg Cardiology Consultants
• Clarksburg Cardiovascular PLLC
• Clarksburg ENT - Uha
• Clarksburg Surgical Specialists
• Lauren Hope Clarkson, MOT

• Social Worker in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.