Samantha McCormick, MSW

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

18 Newton St
Brockton, MA 02301-5115

Phone

(508) 583-6498

Fax

(508) 583-3775

NPI assigned

Sep 21, 2022

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Family and Community Resources, Inc.

  • Community/Behavioral Health Agency
  • Brockton, MA
  • NPI 1821159880
  NPD

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1497478804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 NEWTON ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015115",
            "telephone_number": "508-583-6498",
            "fax_number": "508-583-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 NEWTON ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015115",
            "telephone_number": "508-583-6498",
            "fax_number": "508-583-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "SAMANTHA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neena Nicole McConnico, M.A., LMHC
• Michael J McCoobery, MD
• Joseph R McCool, EDD
• Elaine M McCormack, LICSW
• Teresa Ann McCormack
• Makayla McCoy
• Carolyn M McCrosson, MSW, LICSW
• James Edward McCue
• Kathleen Ann McCullough, LCSW
• Kaitlin R. McCusker

• Community Health Worker in Brockton, MA
• Providers in Brockton, MA by specialty
• Community Health Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.