Samantha Jessica Inniss, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13487 Issued in CT

Practice address

18 Briarwood Dr
Windsor, CT 06095-4470

Phone

(860) 922-0060

NPI assigned

Dec 21, 2020

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 names 1

• Samantha Jessica Edwards Other name

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

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Sams Wellness and Therapeutic Services

  • Clinical Social Worker
  • Bloomfield, CT
  • NPI 1154195600
  NPD Authorized official
• Cambridge Mental Health, LLC

  • Clinical Social Worker
  • Bloomfield, CT
  • NPI 1336639442
  NPD (past)

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

{
    "created_epoch": "1608508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1821685116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 BRIARWOOD DR",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060954470",
            "telephone_number": "860-922-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 BRIARWOOD DR",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060954470",
            "telephone_number": "860-922-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INNISS",
        "first_name": "SAMANTHA",
        "middle_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-21",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "13487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "EDWARDS",
            "middle_name": "JESSICA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Walter R Ialacci, DC
• Ian D Kleinhen MD PLLC
• Indigo Counseling Services LLC
• Inner Reach Therapeutics, LLC
• Inner Vibrance, LLC
• Mohamed Issa
• Quiana Tiesheia Jackson-Ashe
• Shateria Jackson
• Jared Jacobskind
• Patricia Langevin James, LCSW

• Clinical Social Worker in Windsor, CT
• Providers in Windsor, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.