Active NPI
Samantha Dorn, LCSW
- Social Worker
- Montgomery, NY
National Provider Identifier
1689359135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 100914
- Practice address
- 1128 Ny-17K, Ste 1
Ste 1
Montgomery, NY 12549 - Phone
- (845) 202-1318
- NPI assigned
- Jun 21, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 100914 | NY | Primary |
Addresses
Primary practice location
1128 Ny-17K, Ste 1
Ste 1
Montgomery, NY 12549
Mailing address
100 Hillside Dr Apt D7
Middletown, NY 10941-1333
Phone (845) 791-0681
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 |
|---|---|---|---|
| 100914 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758153600000",
"number": "1689359135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HILLSIDE DR APT D7",
"city": "MIDDLETOWN",
"state": "NY",
"postal_code": "109411333",
"telephone_number": "845-791-0681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1128 NY-17K, STE 1",
"address_2": "STE 1",
"city": "MONTGOMERY",
"state": "NY",
"postal_code": "12549",
"telephone_number": "845-202-1318"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORN",
"first_name": "SAMANTHA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-06-21",
"last_updated": "2025-09-18",
"certification_date": "2025-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "100914",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.