Samantha Bennahum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

080816-1 Issued in NY

Practice address

3515 75TH St Apt 208
Jackson HTS, NY 11372-4427

Phone

(917) 837-9194

NPI assigned

Sep 27, 2020

Last updated

Sep 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Opus Therapy LCSW, PC

  • Clinical Social Worker
  • Jackson HTS, NY
  • NPI 1770184459
  NPD Authorized official

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

{
    "created_epoch": "1601164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601164800000",
    "number": "1770190407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 75TH ST APT 208",
            "city": "JACKSON HTS",
            "state": "NY",
            "postal_code": "113724427",
            "telephone_number": "917-837-9194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 75TH ST APT 208",
            "city": "JACKSON HTS",
            "state": "NY",
            "postal_code": "113724427",
            "telephone_number": "917-837-9194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNAHUM",
        "first_name": "SAMANTHA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-27",
        "last_updated": "2020-09-27",
        "certification_date": "2020-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "080816-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Jackson HTS, NY
• Providers in Jackson HTS, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2020; 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.