Samantha Elizabeth Davis, ACSW, CADC-CAS

Primary specialty

Social WorkerTaxonomy code 104100000X

License

ASW118225 Issued in CA

Practice address

658 E Brier Dr Ste 200
San Bernardino, CA 92408-2847

Phone

(909) 501-0705

Fax

(909) 387-7611

NPI assigned

Sep 5, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• County of San Bernardino

  dba Centralized Child Intensive Case Mgmt Services

  • Adolescent and Children Mental Health Clinic/Center
  • San Bernardino, CA
  • NPI 1043415037
  NPD
• Benchmark Transitions

  • Addiction (Substance Use Disorder) Counselor
  • Redlands, CA
  • NPI 1881186245
  NPD (past)

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

{
    "created_epoch": "1536105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1891277877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 E BRIER DR STE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082847",
            "telephone_number": "909-501-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 E BRIER DR STE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082847",
            "telephone_number": "909-501-0705",
            "fax_number": "909-387-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SAMANTHA",
        "middle_name": "ELIZABETH",
        "credential": "ACSW, CADC-CAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-05",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW118225",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "C040930217",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "ASW118225",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA CONSORTIUM OF ADDICTION PROGRAMS AND PROFESSIONALS",
            "identifier": "C040930217",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lashandia Davis
• Mia Davis
• Michael Anthony Davis I
• Mylaka Davis
• Nate Yvonne Nicole Davis
• Sherronda Davis
• Susan Nmi Davis, LMFT
• Vickie Davis
• Jahanshah Davoodifard
• Hakob Grigor Davtyan, M.D.

• Social Worker in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.