Active NPI
Charlene Samuels
- Social Worker
- Lawrenceville, GA
National Provider Identifier
1497591028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- MSW012018
- Practice address
- 1495 Duluth Hwy Ste F
Lawrenceville, GA 30043-5143 - Phone
- (321) 352-9187
- NPI assigned
- Jul 3, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | MSW012018 | GA | Primary |
| Social Worker | 104100000X | 9693 | CT |
Addresses
Primary practice location
1495 Duluth Hwy Ste F
Lawrenceville, GA 30043-5143
Mailing address
116 Chase Landing Dr
Loganville, GA 30052-6523
Phone (321) 352-9187
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MSW012018 | GA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779667200000",
"number": "1497591028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 CHASE LANDING DR",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300526523",
"telephone_number": "321-352-9187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1495 DULUTH HWY STE F",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300435143",
"telephone_number": "321-352-9187"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUELS",
"first_name": "CHARLENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-03",
"last_updated": "2026-05-25",
"certification_date": "2026-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "GA",
"license": "MSW012018",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CT",
"license": "9693",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.