Vincent Arthur Samuolis, LCSW, LADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

003544 Issued in CT

Practice address

251 Main St
Old Saybrook, CT 06475-2357

Phone

(203) 804-6251

Fax

(203) 453-0170

NPI assigned

Mar 8, 2013

Sex

Male

Sole proprietor

Yes

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 CT

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1362700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362700800000",
    "number": "1629319173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 WHITE BIRCH DR",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372165",
            "telephone_number": "203-804-6251",
            "fax_number": "203-453-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 MAIN ST",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064752357",
            "telephone_number": "203-804-6251",
            "fax_number": "203-453-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUOLIS",
        "first_name": "VINCENT",
        "middle_name": "ARTHUR",
        "name_prefix": "Mr.",
        "credential": "LCSW, LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-08",
        "last_updated": "2013-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "000277",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "003544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Gerard Ryan, LICAC
• Monique Elise Salvas, PA-C
• Samson Dental
• Samson Dental
• Wilford Samson, D.D.S
• Brittany Sanchez, LPC
• Nancy Lynn Sandner, RPT
• Emily-Rose Santamaria, LCSW
• Walter Mauricio Saquipulla
• Saybrook Center LLC

• Clinical Social Worker in Old Saybrook, CT
• Providers in Old Saybrook, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.