Individual provider Active NPI

Samantha Ruth Flint, LCSW, LISW

  • Clinical Social Worker
  • Fort Moore, GA
National Provider Identifier
1629457486
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
256249 Issued in KY
Practice address
6600 Van Aalst Blvd
Fort Moore, GA 31905-2102
Phone
(863) 370-3274
NPI assigned
May 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 7251 KY
Clinical Social Worker 1041C0700X OH
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X 256249 KY Primary

Addresses

Primary practice location

6600 Van Aalst Blvd
Fort Moore, GA 31905-2102

Mailing address

6600 Van Aalst Blvd
Fort Moore, GA 31905-2102

Other practice location 1

2000 Ring Rd
Elizabethtown, KY 42701-9454
Phone (270) 506-2730

Other practice location 2

1311 N Dixie Hwy Bldg D
Elizabethtown, KY 42701-2621
Phone (270) 360-0419

Other practice location 3

6100 S Mason Montgomery Rd
Mason, OH 45040-3708
Phone (513) 398-5025

Other practice location 4

7281 Dumosa Ave
Yucca Valley, CA 92284-3769
Phone (760) 853-4755

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

LicenseStateTypeSpecialty
7251KYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1629457486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD",
            "city": "FORT MOORE",
            "state": "GA",
            "postal_code": "319052102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD",
            "city": "FORT MOORE",
            "state": "GA",
            "postal_code": "319052102",
            "telephone_number": "863-370-3274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Ring Rd",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "KY",
            "postal_code": "427019454",
            "country_code": "US",
            "telephone_number": "270-506-2730",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1311 N Dixie Hwy Bldg D",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "KY",
            "postal_code": "427012621",
            "country_code": "US",
            "telephone_number": "270-360-0419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6100 S Mason Montgomery Rd",
            "address_purpose": "LOCATION",
            "city": "Mason",
            "state": "OH",
            "postal_code": "450403708",
            "country_code": "US",
            "telephone_number": "513-398-5025",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7281 Dumosa Ave",
            "address_purpose": "LOCATION",
            "city": "Yucca Valley",
            "state": "CA",
            "postal_code": "922843769",
            "country_code": "US",
            "telephone_number": "760-853-4755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLINT",
        "first_name": "SAMANTHA",
        "middle_name": "RUTH",
        "credential": "LCSW, LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-27",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "7251",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "256249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Moore, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.