Individual provider Active NPI

Erica Leigh Samek, LCSW-R

  • Clinical Social Worker
  • Hamburg, NY
National Provider Identifier
1477690303
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
077849 Issued in NY
Practice address
4200 Sheva Lane
Hamburg, NY 14075-1315
Phone
(716) 548-0383
Fax
(716) 926-6252
NPI assigned
Jan 31, 2007
Last updated
Dec 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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 077849 NY Primary

Addresses

Primary practice location

4200 Sheva Lane
Hamburg, NY 14075-1315

Mailing address

Healing Lives From Within
4200 Sheva Lane
Hamburg, NY 14075-1315
Phone (716) 548-0383

Other identifiers 1

IdentifierTypeStateIssuer
03174036MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20131023000003 NY Practitioner - Clinical Social Worker 3476702507 Practice locations: Hamburg, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
State University of New York at Buffalo School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4200 Sheva LN
Hamburg, NY 14075-1315
Phone (716) 548-0383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
077849NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kelly M McCall LCSW, PLLC Clinical PastSince Oct 7, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1477690303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HEALING LIVES FROM WITHIN",
            "address_2": "4200 SHEVA LANE",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140751315",
            "telephone_number": "716-548-0383",
            "fax_number": "716-926-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 SHEVA LANE",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140751315",
            "telephone_number": "716-548-0383",
            "fax_number": "716-926-6252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMEK",
        "first_name": "ERICA",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03174036",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, NY

Sources for this page

Verify at the official NPI Registry.