Samantha Romero, LCSW, CADC-III

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

114069 Issued in CA

Practice address

3375 Montagne Way
Thousand Oaks, CA 91362

Phone

(310) 924-1208

NPI assigned

Mar 23, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Samantha Szelog Former name

Medicare fee-for-service enrollment

Enrolled in CA, MT2 enrollments

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 2

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Clinical

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, MT

  Medicare reassignment NPD
• Lacuna Healing Therapy PC

  • Clinical Social Worker
  • Thousand Oaks, CA
  • NPI 1336913615
  NPD Authorized official

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

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1962896498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 E IDAHO ST # 203",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599014137",
            "telephone_number": "310-924-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3375 MONTAGNE WAY",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "91362",
            "telephone_number": "310-924-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "SAMANTHA",
        "credential": "LCSW, CADC-III",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-23",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "B0000630320",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-63673",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "114069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "SZELOG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rolling Oaks Pharmacy Inc
• Rolling Oaks Radiology Medical Corp Corporation
• Rolling Oaks Surgery Center LLC
• Amanda Romero
• Kayla Mae Romero, RDN
• Tania Lineth Romero
• Zaida Lizeth Romero, COTA/L
• Marco Antonio Romo
• Billiejo Rompal
• Ronald F Young Medical Corporation

• Clinical Social Worker in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.