Active NPI
Samantha Jo Fox, LCSWA
- Clinical Social Worker
- Raleigh, NC
National Provider Identifier
1780162149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- PO12775
- Practice address
- 8376 Six Forks Rd Ste 104
Raleigh, NC 27615-5095 - Phone
- (919) 900-7438
- Fax
- (919) 900-7576
- NPI assigned
- Jul 29, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | PO12775 | NC | Primary |
Addresses
Primary practice location
8376 Six Forks Rd Ste 104
Raleigh, NC 27615-5095
Mailing address
7604 Green Level Church Rd
Apex, NC 27523-9438
Phone (919) 602-0324
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PO12775 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fernandez Community Center, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Raleigh, NC
- NPI 1033465075
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532822400000",
"number": "1780162149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7604 GREEN LEVEL CHURCH RD",
"city": "APEX",
"state": "NC",
"postal_code": "275239438",
"telephone_number": "919-602-0324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8376 SIX FORKS RD STE 104",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276155095",
"telephone_number": "919-900-7438",
"fax_number": "919-900-7576"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOX",
"first_name": "SAMANTHA",
"middle_name": "JO",
"credential": "LCSWA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-29",
"last_updated": "2018-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "PO12775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.