Individual provider Active NPI

Samantha Dufva, LCSW

  • Clinical Social Worker
  • Lees Summit, MO
National Provider Identifier
1922354109
Registry record updated Jul 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2012018581 Issued in MO
Practice address
901 NE Independence Ave
Lees Summit, MO 64086-5544
Phone
(816) 347-3032
NPI assigned
Jul 25, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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 2012018581 MO Primary

Addresses

Primary practice location

901 NE Independence Ave
Lees Summit, MO 64086-5544

Mailing address

901 NE Independence Ave
Lees Summit, MO 64086-5544
Phone (816) 347-3032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20130218000526 MO Practitioner - Clinical Social Worker 1850546045 Practice locations: Lees Summit, MO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

615 SW 3Rd St
Samantha Dufva Emg
Lees Summit, MO 64063-2212
Phone (816) 223-2197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343174400000",
    "number": "1922354109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 NE INDEPENDENCE AVE",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865544",
            "telephone_number": "816-347-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 NE INDEPENDENCE AVE",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640865544",
            "telephone_number": "816-347-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFVA",
        "first_name": "SAMANTHA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2012-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2012018581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

Verify at the official NPI Registry.