Samantha J Brockmeyer, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2507429 Issued in OH

Practice address

25111 Country Club Blvd Ste 290
North Olmsted, OH 44070-5330

Phone

(216) 468-5000

NPI assigned

Aug 2, 2018

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 Jo Brockmeyer Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Psychological & Behavioral Consultants, LLC

  • Psychiatry Physician
  • Beachwood, OH
  • NPI 1811915713
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1962980888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25111 COUNTRY CLUB BLVD STE 290",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440705330",
            "telephone_number": "216-468-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Berea Cmns Ste 200",
            "address_purpose": "LOCATION",
            "city": "Berea",
            "state": "OH",
            "postal_code": "440172534",
            "country_code": "US",
            "telephone_number": "216-418-7397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROCKMEYER",
        "first_name": "SAMANTHA",
        "middle_name": "J",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-02",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.169590",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2507429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "BROCKMEYER",
            "middle_name": "JO",
            "credential": "LISW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Drew Porter Bradford
• Lenore Natalia Braford
• Ernest B Brazina, O.D.
• Christine G Brewer, PHD
• Amy J Brinkman, MSW LSW
• Gary Brod
• Lydia Marie Bronson, M.ED, BCBA, COBA
• Kathy Brookhart
• Donna Brown
• Buckeye Forest at North Olmstead LLC

• Clinical Social Worker in North Olmsted, OH
• Providers in North Olmsted, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.