Samantha Clark, LCSW in Tampa, FL - Medicare Social Worker Provider

Samantha Clark, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Tampa, Florida. Her current practice location is 18002 Richmond Place Dr Apt 323, Tampa, Florida. You can reach out to her office (for appointments etc.) via phone at (352) 346-8572.

Samantha Clark is licensed to practice in Florida (license number SW18383) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1215505706.

Contact Information

	Samantha Clark, LCSW
	18002 Richmond Place Dr Apt 323, Tampa, FL 33647-1725
	(352) 346-8572
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Samantha Clark
Gender	Female
Speciality	Social Worker - Clinical
Location	18002 Richmond Place Dr Apt 323, Tampa, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1215505706
Provider Enumeration Date: 06/11/2021
Last Update Date: 06/11/2021

Medicare PECOS Information:

PECOS PAC ID: 4385085380
Enrollment ID: I20240508001777

Medical Identifiers

Medical identifiers for Samantha Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1215505706	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	SW18383 (Florida)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Samantha Clark allows following entities to bill medicare on her behalf.

Entity Name	Baycare Behavioral Health Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1225312549 PECOS PAC ID: 4688649122 Enrollment ID: O20040830000131

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samantha Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Samantha Clark, LCSW 18002 Richmond Place Dr Apt 323, Tampa, FL 33647-1725 Ph: (352) 346-8572	Samantha Clark, LCSW 18002 Richmond Place Dr Apt 323, Tampa, FL 33647-1725 Ph: (352) 346-8572

Reviews and Comments

Social Worker in Tampa, FL

Darlene H Allen, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5707 N 22nd St, Tampa, FL 33610 Phone: 813-239-8000 Fax: 813-272-3766
Bryant C Barbour, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4422 E Columbus Dr., Tampa, FL 33605 Phone: 813-384-4079
Ms. Clarissia Brown, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2021 Busch Blvd, Tampa, FL 33612 Phone: 813-631-4370 Fax: 813-631-4399
Sasha J Thompson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 612 N Gomez Ave, Tampa, FL 33609 Phone: 813-787-1623
Jennifer Faith Gobeli, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 8905 Regents Park Dr Ste 230, Tampa, FL 33647 Phone: 727-314-5468
Ms. Linda L Mann, LCSW, CAP Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4422 E Columbus Dr, Tampa, FL 33605 Phone: 813-980-3866 Fax: 813-984-8374
Amy Lynn Abdnour, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 200 S Hoover Blvd Ste 185, Tampa, FL 33609 Phone: 813-679-3845

Samantha Clark, LCSW - Medicare Clinical Social Worker in Tampa, FL