Wanda Samuels-Jackson, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

21262 Issued in MD

Practice address

1826 Woodlawn Dr Ste 3
Gwynn Oak, MD 21207-4050

Phone

(410) 800-2121

Fax

(443) 478-4716

NPI assigned

Apr 2, 2026

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Beautiful Hearts and Minds Health Services

  • Community/Behavioral Health Agency
  • Woodlawn, MD
  • NPI 1841701794

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1775088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1528909736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8626 HAYSHED LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452604",
            "telephone_number": "410-800-2121",
            "fax_number": "443-478-4716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 WOODLAWN DR STE 3",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212074050",
            "telephone_number": "410-800-2121",
            "fax_number": "443-478-4716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8626 Hayshed Ln",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210452604",
            "country_code": "US",
            "telephone_number": "410-800-2121",
            "fax_number": "443-478-4716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUELS-JACKSON",
        "first_name": "WANDA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-02",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "MD",
            "license": "21262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Refresh Pain and Wellness, LLC
• Renace LLC
• Kelly Nicole Richardson, LCSW-C
• Robinson Entities LLC
• Stacey Russell, LMSW
• Andrea Lynnette Samuels, D.C.
• Gibrilla Mustapha Sannoh, NP
• Leila Seyedsalari, DDS
• Jasmin Shabazz, CNA
• Jacob Elias Singer, LMSW

• Social Worker in Gwynn Oak, MD
• Providers in Gwynn Oak, MD by specialty
• Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.

Verify at the official NPI Registry.