Samantha Loraine Blanco, MSW, BSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C014851 Issued in NC

Practice address

220 Swinburne St
Raleigh, NC 27610-1834

Phone

(919) 212-7000

NPI assigned

Feb 16, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Samantha Loraine Baptiste Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Envision Solutions Therapy

  • Mental Health Counselor
  • Wake Forest, NC
  • NPI 1134077076
  NPD Authorized official

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1770176240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SUNNYBROOK RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101808",
            "telephone_number": "910-580-0594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SWINBURNE ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101834",
            "telephone_number": "919-212-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "SAMANTHA",
        "middle_name": "LORAINE",
        "credential": "MSW, BSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-16",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P014362",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C014851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "BAPTISTE",
            "middle_name": "LORAINE",
            "credential": "MSW, BSW, LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary McDaniel Blanchard, NP
• Nicholas Ronald Blanchard, PHARMD
• Patricia Blanchard, PA-C
• Phyllis Anne Blanchard, CRNA
• Alexandra Blanco
• Alister Bland
• Dana Coltrain Bland, COTA/L
• Erin Kay Bland, LSCW
• Wesley Kevin Bland, PA-C
• Alicia A Blankenship, LCSW

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.