Individual provider Active NPI

Samantha Prouty

  • Clinical Social Worker
  • Spokane, WA
National Provider Identifier
1629600671
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWIA.SC.70142319 Issued in WA
Practice address
107 S Division St
Spokane, WA 99202-1510
Phone
(208) 209-6830
NPI assigned
Feb 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X WA
Clinical Social Worker 1041C0700X SWIA.SC.70142319 WA Primary
Counselor 101Y00000X CG61214246 WA

Addresses

Primary practice location

107 S Division St
Spokane, WA 99202-1510

Mailing address

107 S Division St
Spokane, WA 99202-1510

Other practice location 1

1819 E Springfield Ave Ste H
Spokane, WA 99202-2954
Phone (509) 999-5657

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

LicenseStateTypeSpecialty
CG61214246WAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Frontier Behavioral Health 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": "1581033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1629600671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S DIVISION ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S DIVISION ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021510",
            "telephone_number": "208-209-6830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1819 E Springfield Ave Ste H",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992022954",
            "country_code": "US",
            "telephone_number": "509-999-5657",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROUTY",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-07",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SWIA.SC.70142319",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG61214246",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.