Samantha Cannon Roberts, LCSW, LCDC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

105997 Issued in TX

Practice address

1101 Satellite VW Unit 603
Round Rock, TX 78665-1592

Phone

(512) 843-1154

Fax

(512) 894-6412

NPI assigned

Mar 20, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kindly Psychotherapy, PLLC

  • Clinical Social Worker
  • Round Rock, TX
  • NPI 1831034537
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1699535484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 MAIS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786263058",
            "telephone_number": "512-843-1154",
            "fax_number": "512-894-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SATELLITE VW UNIT 603",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651592",
            "telephone_number": "512-843-1154",
            "fax_number": "512-894-6412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "SAMANTHA",
        "middle_name": "CANNON",
        "credential": "LCSW, LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-20",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "16660",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "105997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dan H Roberts, PH.D.
• Imelda Roberts, RN
• Jaclyn Roberts
• James H. Roberts
• Judy Roberts, LPC
• Scott C Robertson, MD
• Emily Nicole Robinett-Ferrara, PHD
• Timothy P Robins, M.D.,P.A.
• Alysha Robinson
• Damien Robinson

• Clinical Social Worker in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.