Carmen Louise Sample, MSW, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1736 Issued in CO

Practice address

606 Mountain View Ave
Longmont, CO 80501-2779

Phone

(303) 523-8057

Fax

(303) 772-0629

NPI assigned

Nov 24, 2009

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

Enrolled in CO

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

Specialty

Clinical Social Worker

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Sample Therapy Services

  • Clinical Social Worker
  • Longmont, CO
  • NPI 1568791911
  Medicare reassignment Authorized official
• Sample Services

  • Clinical Social Worker
  • Longmont, CO
  • NPI 1184594533
  Authorized official Same address or phone
• Sample Services

  • Clinical Social Worker
  • Fort Collins, CO
  • NPI 1316817752
  Authorized official Same address or phone
• Sample Services

  • Clinical Social Worker
  • Fort Collins, CO
  • NPI 1447120894
  Authorized official Same address or phone
• Sample Services

  • Clinical Social Worker
  • Longmont, CO
  • NPI 1700245578
  Authorized official Same address or phone
• Sample Services

  • Clinical Social Worker
  • Thornton, CO
  • NPI 1821968272
  Authorized official Same address or phone
• Sample Supports

  • Day Training/Habilitation Specialist
  • Longmont, CO
  • NPI 1255201695
  Authorized official Same address or phone
• Sample Supports

  • Community/Behavioral Health Agency
  • Longmont, CO
  • NPI 1649577453
  Authorized official Same address or phone
• Sample Supports, LLC

  • Day Training/Habilitation Specialist
  • Fort Collins, CO
  • NPI 1255903142
  Authorized official Same address or phone
• Sample Supports, LLC

  • Day Training/Habilitation Specialist
  • Longmont, CO
  • NPI 1295492387
  Authorized official Same address or phone
• Sample Supports, LLC

  • Day Training/Habilitation Specialist
  • Longmont, CO
  • NPI 1326610213
  Authorized official Same address or phone
• Sample Supports, LLC

  • Day Training/Habilitation Specialist
  • Loveland, CO
  • NPI 1407428394
  Authorized official Same address or phone

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1609104991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 MOUNTAIN VIEW AVE",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805012779",
            "telephone_number": "303-523-8057",
            "fax_number": "303-772-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 MOUNTAIN VIEW AVE",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805012779",
            "telephone_number": "303-523-8057",
            "fax_number": "303-772-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPLE",
        "first_name": "CARMEN",
        "middle_name": "LOUISE",
        "credential": "MSW, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-24",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "1736",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "249",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sample Supports, LLC
• Sample Supports, LLC
• Sample Supports, LLC
• Sample Supports, LLC (Bross Street Assisted Living)
• Sample Therapy Services
• James W Sampson, NP
• Karissa Anne Sampson, PA
• Stephen Paul Sampson, DMD
• Sams West Inc (Sam's Pharmacy 10-4987)
• Karis Samson, LMT

• Clinical Social Worker in Longmont, CO
• Providers in Longmont, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.