Active NPI
Samantha Manos, LCSW-C
- Social Worker
- Severna Park, MD
National Provider Identifier
1578975272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 19900
- Practice address
- 770 Ritchie Hwy Ste W16
Severna Park, MD 21146-4158 - Phone
- (410) 294-0152
- NPI assigned
- May 29, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 19900 | MD | Primary |
Addresses
Primary practice location
770 Ritchie Hwy Ste W16
Severna Park, MD 21146-4158
Mailing address
1460 Stoney Point Way
Stoney Beach, MD 21226-2141
Phone (434) 417-0142
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19900 | MD | MD | Ergonomics Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591747200000",
"number": "1578975272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1460 STONEY POINT WAY",
"city": "STONEY BEACH",
"state": "MD",
"postal_code": "212262141",
"telephone_number": "434-417-0142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 RITCHIE HWY STE W16",
"city": "SEVERNA PARK",
"state": "MD",
"postal_code": "211464158",
"telephone_number": "410-294-0152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANOS",
"first_name": "SAMANTHA",
"name_prefix": "Mrs.",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-29",
"last_updated": "2020-06-10",
"certification_date": "2020-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "19900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Severna Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.