Individual provider Active NPI

Samantha Rochelle Smalls, LCSW

  • Clinical Social Worker
  • Hartford, CT
National Provider Identifier
1790834307
Registry record updated Dec 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7787 Issued in CT
Practice address
500 Vine St
Hartford, CT 06112-1639
Phone
(860) 297-0843
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2016

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 7787 CT Primary

Addresses

Primary practice location

500 Vine St
Hartford, CT 06112-1639

Mailing address

15 April Way
Bloomfield, CT 06002-2805
Phone (860) 989-5331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20121030000094 CT Practitioner - Clinical Social Worker 1658521562 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New Chapter Counseling Services, LLC Current Accepting new patients
State of Connecticut CurrentSince Mar 1, 2012 Accepting new patients
State of Connecticut CurrentSince Mar 1, 2012 Accepting new patients

Locations

51 Coventry St
Hartford, CT 06112
Phone (860) 297-0800

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

500 Vine St
Hartford, CT 06112
Phone (860) 293-6400

Organizations & group practices 3

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1790834307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 APRIL WAY",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022805",
            "telephone_number": "860-989-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 VINE ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121639",
            "telephone_number": "860-297-0843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALLS",
        "first_name": "SAMANTHA",
        "middle_name": "ROCHELLE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "7787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.