Samantha Marie Dittrich, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

228021 Issued in MA

Practice address

169 Libbey Pkwy
Weymouth, MA 02189-3189

Phone

(781) 474-5287

NPI assigned

Aug 13, 2019

Last updated

Jan 30, 2023By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

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.

• Child and Family Psychological Services, PLLC

  dba LifeStance Health

  • Psychologist
  • Norwood, MA
  • NPI 1912987181

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1811543119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 FOREST ST",
            "city": "KINGSTON",
            "state": "MA",
            "postal_code": "023642197",
            "telephone_number": "781-812-6302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 LIBBEY PKWY",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021893189",
            "telephone_number": "781-474-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTRICH",
        "first_name": "SAMANTHA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "228021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF SOCIAL WORKERS",
            "identifier": "228021",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Doreen Lee Dillon
• Courtney Marie Dilworth, BS.DS
• Isabella Dimare, NP
• Cheng Ding, MD
• Virginia Marie Disanto, LICSW
• Michael V Ditullio, M.D.
• Amy Beth Ditzel, RN, MS, NNP
• Ninveh J Dizayer
• Ekta M Doctor, D.M.D
• Kristin Elizabeth Doherty

• Clinical Social Worker in Weymouth, MA
• Providers in Weymouth, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.