SAMANTHA CLARK (LCSW) – Clinical Social Worker, NPI 1215505706
Clinical Social Worker
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
3,374 CLINICAL SOCIAL WORKER in FL
Provider Addresses for SAMANTHA CLARK (LCSW)
14527 7TH ST
DADE CITY, FL 335233102
Phone: (727) 521-1474
Type: Location
18002 RICHMOND PLACE DR APT 323
TAMPA, FL 336471725
Phone: (352) 346-8572
Type: Mailing
4918 N HABANA AVE
TAMPA, FL 336146815
Phone: (866) 762-1743
Fax: (727) 816-1222
Type: Location
2995 DREW ST FL 2
CLEARWATER, FL 337593012
Phone: (727) 532-0002
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-05-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240508001777 | I | Clinical Social Worker | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33523)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | KS | |
| P S Y C H I A T R Y | MA | |
| Nurse Practitioner | FL | |
| Clinical Social Worker | FL | |
| - | FL | |
| P S Y C H I A T R Y | FL | |
| - | CT | |
| Clinical Social Worker | FL | |
| - | SC | |
| - | FL |
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