Individual provider Active NPI

Samantha T Camerino, LCSW

  • Clinical Social Worker
  • Denver, CO
National Provider Identifier
1629423397
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09925307 Issued in CO
Practice address
2111 Champa St
Denver, CO 80205-2529
Phone
(303) 312-2217
Fax
(303) 293-2309
NPI assigned
Apr 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW.09925307 CO Primary
Social Worker 104100000X 72090984 NY

Addresses

Primary practice location

2111 Champa St
Denver, CO 80205-2529

Mailing address

2111 Champa St
Denver, CO 80205-2529
Phone (303) 312-2217

Other practice location 1

14 E 28th St
Career Network
New York, NY 10016-7448
Phone (347) 563-6933

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20181004001215 CO Order and Referring Only - Clinical Social Worker 3678825528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
72090984NYMDSocial Worker
CSW.09925307COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Urban Community Services 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.

NPI Registry JSON

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

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1629423397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 CHAMPA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052529",
            "telephone_number": "303-312-2217",
            "fax_number": "303-293-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 CHAMPA ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802052529",
            "telephone_number": "303-312-2217",
            "fax_number": "303-293-2309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 E 28th St",
            "address_2": "Career Network",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100167448",
            "country_code": "US",
            "telephone_number": "347-563-6933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMERINO",
        "first_name": "SAMANTHA",
        "middle_name": "T",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-29",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09925307",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "72090984",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.