Samara Marie Davis Tobeck, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

31856 Issued in MN

Practice address

16123 Grant Utley Ave NW
Cass Lake, MN 56601

Phone

(218) 335-3050

Fax

(218) 335-4410

NPI assigned

Mar 6, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1741219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1891593604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 SAILSTAR DR NW",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "56601",
            "telephone_number": "320-815-4308",
            "fax_number": "218-335-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16123 GRANT UTLEY AVE NW",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "56601",
            "telephone_number": "218-335-3050",
            "fax_number": "218-335-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBECK",
        "first_name": "SAMARA",
        "middle_name": "MARIE DAVIS",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-06",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "31856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Cass Lake, MN
• Providers in Cass Lake, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; 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.