Active NPI
Samantha Lakes
- Clinical Social Worker
- Kettering, OH
National Provider Identifier
1669985735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- S1500257
- Practice address
- 1785 Big Hill Rd
Kettering, OH 45439-2219 - Phone
- (937) 367-3911
- NPI assigned
- Nov 13, 2017
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | S1500257 | OH | Primary |
Addresses
Primary practice location
1785 Big Hill Rd
Kettering, OH 45439-2219
Mailing address
1785 Big Hill Rd
Kettering, OH 45439-2219
Phone (937) 367-3911
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 |
|---|---|---|---|
| S1500257 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children Have Options in Caring Environments | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/choicesohio/r4/
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
- Dayton, OH
- NPI 1861798662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510531200000",
"number": "1669985735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1785 BIG HILL RD",
"city": "KETTERING",
"state": "OH",
"postal_code": "454392219",
"telephone_number": "937-367-3911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1785 BIG HILL RD",
"city": "KETTERING",
"state": "OH",
"postal_code": "454392219",
"telephone_number": "937-367-3911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKES",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-13",
"last_updated": "2017-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "S1500257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kettering, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.