Active NPI
Samuel N Dockery, LCSW-A, LCAS-A
- Clinical Social Worker
- Bryson City, NC
National Provider Identifier
1902546286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P017198
- Practice address
- 264 Highway 19 S Ste 4
Bryson City, NC 28713-1134 - Phone
- (828) 341-1060
- Fax
- (828) 341-1804
- NPI assigned
- Apr 1, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCAS-28270 | NC | |
| Clinical Social Worker | 1041C0700X | P017198 | NC | Primary |
Addresses
Primary practice location
264 Highway 19 S Ste 4
Bryson City, NC 28713-1134
Mailing address
220 5TH Ave E
Hendersonville, NC 28792-4377
Phone (828) 692-4289
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCAS-28270 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| P017198 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731456000000",
"number": "1902546286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 5TH AVE E",
"city": "HENDERSONVILLE",
"state": "NC",
"postal_code": "287924377",
"telephone_number": "828-692-4289",
"fax_number": "828-696-1794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "264 HIGHWAY 19 S STE 4",
"city": "BRYSON CITY",
"state": "NC",
"postal_code": "287131134",
"telephone_number": "828-341-1060",
"fax_number": "828-341-1804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOCKERY",
"first_name": "SAMUEL",
"middle_name": "N",
"name_prefix": "Mr.",
"credential": "LCSW-A, LCAS-A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-01",
"last_updated": "2024-11-13",
"certification_date": "2024-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "LCAS-28270",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P017198",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bryson City, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.