Individual provider Active NPI

Samantha L Miller, LCSW

  • Clinical Social Worker
  • Tucson, AZ
National Provider Identifier
1750126405
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22342 Issued in AZ
Practice address
839 W Congress St
Tucson, AZ 85745-2819
Phone
(520) 670-3909
Fax
(520) 309-2560
NPI assigned
Jun 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 22342 AZ Primary

Addresses

Primary practice location

839 W Congress St
Tucson, AZ 85745-2819

Mailing address

839 W Congress St
Tucson, AZ 85745-2819
Phone (520) 670-3909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20241009000281 AZ Practitioner - Clinical Social Worker 2264963677 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22342AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
El Rio Santa Cruz Neighborhood Health Center, Inc CurrentSince Sep 23, 2024 Accepting new patients
El Rio Santa Cruz Neighborhood Health Center, Inc CurrentSince Sep 23, 2024 Accepting new patients

Locations

3655 E Grant Rd
Tucson, AZ 85716
Phone (520) 440-6323

839 W Congress St
Tucson, AZ 85745
Phone (520) 670-3707

Organizations & group practices 2

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": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1750126405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 W CONGRESS ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452819",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 W CONGRESS ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452819",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SAMANTHA",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-26",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "22342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.