Individual provider Active NPI

Samantha Ruth Goldfrad, MSW, LCSW, LICSW

  • Clinical Social Worker
  • Canton, MA
National Provider Identifier
1811685977
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
126785 Issued in MA
Practice address
123 Revere St Unit a
Canton, MA 02021-2984
Phone
(610) 529-6691
NPI assigned
Apr 26, 2023
Last updated
Dec 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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 126785 MA Primary

Addresses

Primary practice location

123 Revere St Unit a
Canton, MA 02021-2984

Mailing address

123 Revere St Unit a
Canton, MA 02021-2984
Phone (610) 529-6691

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240220002526 MA Practitioner - Clinical Social Worker 5193169951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

101 Adams St
Suite 26
Quincy, MA 02169-2022
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
126785MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Jan 6, 2024 Accepting new patients

Locations

872 Massachusetts Ave
Ste 2-2
Cambridge, MA 02139
Phone (617) 395-5806

101 Adams St
Ste 26
Quincy, MA 02169
Phone (469) 826-2779

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1811685977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 REVERE ST UNIT A",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020212984",
            "telephone_number": "610-529-6691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 REVERE ST UNIT A",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020212984",
            "telephone_number": "610-529-6691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDFRAD",
        "first_name": "SAMANTHA",
        "middle_name": "RUTH",
        "credential": "MSW, LCSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "126785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MA

Sources for this page

Verify at the official NPI Registry.