Samantha Cummings, LCSW
Individual provider Active NPI Clinical Social Worker · Boonville, IN
NPI 1710404371 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1710404371
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 34008743A (IN)
- Practice address
- 315 S 3Rd St
Boonville, IN 47601-1723 - Phone
- (812) 897-4776
- NPI assigned
- Aug 24, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southwestern Behavioral Healthcare Inc
Practice addresses (Care Compare)
315 S 3Rd St
Boonville, IN 47601-1723
Phone (812) 897-4776
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200828002171 | IN | Practitioner - Clinical Social Worker | 2961829460 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34008743A | IN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwestern Behavioral Healthcare, Inc. | Current |
Accepting new patients | |
| Southwestern Behavioral Healthcare, Inc. | Current |
Accepting new patients | |
| Hillcrest Washington Youth Home, Inc | Past | Accepting new patients |
Locations
315 S 3rd St
Boonville, IN 47601
Phone (812) 897-4776
415 Mulberry St
Evansville, IN 47713
Phone (812) 436-4232
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34008743A | IN | Yes |
| Social Worker | 104100000X |
Addresses
Primary practice location
315 S 3Rd St
Boonville, IN 47601-1723
Mailing address
415 Mulberry St
Evansville, IN 47713-1230
Phone (812) 423-7791
Other practice location 1
2700 W Indiana St
Evansville, IN 47712
Phone (812) 428-0698
Other providers in Boonville, IN
- Maria Rita Bolisay
- Tyler Cobb
- Rose Angela Coslett
- Lindsey M Cowan
- Marlene Louise Cron
- Deaconess Clinic, Inc
- Deaconess Clinic, Inc
- Deaconess Hospital, Inc.
- Annette Dimmett
- Doctor James E. Eash, D.D.S., P.C.
All providers in Boonville, IN · Clinical Social Worker in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.