Active NPI
Samantha Ann McCarthy
- Social Worker
- Coeur D Alene, ID
National Provider Identifier
1609554591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 43710
- Practice address
- 1620 Northwest Blvd Ste 101
Coeur D Alene, ID 83814-2488 - Phone
- (208) 512-5085
- Fax
- (800) 865-1927
- NPI assigned
- Jul 10, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 43710 | ID | Primary |
Addresses
Primary practice location
1620 Northwest Blvd Ste 101
Coeur D Alene, ID 83814-2488
Mailing address
1620 Northwest Blvd Ste 101
Coeur D Alene, ID 83814-2488
Phone (208) 512-5085
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 |
|---|---|---|---|
| 43710 | ID | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Wellness Clinic of Coeur D Alene Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Coeur D Alene, ID
- NPI 1871713925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688947200000",
"number": "1609554591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1620 NORTHWEST BLVD STE 101",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838142488",
"telephone_number": "208-512-5085",
"fax_number": "800-865-1927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 NORTHWEST BLVD STE 101",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838142488",
"telephone_number": "208-512-5085",
"fax_number": "800-865-1927"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCARTHY",
"first_name": "SAMANTHA",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-10",
"last_updated": "2023-07-10",
"certification_date": "2023-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "43710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coeur D Alene, ID
- Karen Christine McCabe, LCPC
- Michael Joseph McCall I, L.M.S.W.
- Abigail Priestley McCallum, M.D.
- Julie Kathleen McCardell, NURSE PRACTITIONER
- Joseph McCarron, M.A., L.M.F.T.
- Emily Jean McCarty, M.D.
- Stephanie McClelland
- Kyra Nicole McComas, MD
- Brenna Kolokoff McCrummen, M.D.
- Keith Michael McCullough, PA-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.