Samantha J Brockmeyer, BA is a
Social Worker - Clinical based in Avon Lake, Ohio. Samantha J Brockmeyer is licensed to practice in Ohio (license number S.2005043) and her current practice location is
525 Avon Belden Rd Ste 1, Avon Lake, Ohio. She can be reached at her office (for appointments etc.) via phone at
(216) 302-7805.
NPI number for Samantha J Brockmeyer is 1962980888 and her current mailing address is 11905 Hastings Rd, Cleveland, Ohio. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1962980888.
Healthcare Provider's Profile
| Full Name | Samantha J Brockmeyer |
|---|
| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 525 Avon Belden Rd Ste 1, Avon Lake, Ohio |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1962980888
- Provider Enumeration Date: 08/02/2018
- Last Update Date: 07/13/2020
Medical Identifiers
Medical identifiers for Samantha J Brockmeyer such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962980888 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | CDCA.169590 (Ohio) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | S.2005043 (Ohio) | Primary |
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 J Brockmeyer is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Samantha J Brockmeyer, BA
11905 Hastings Rd,
Cleveland, OH 44125-4341
Ph: (440) 453-0566 | Samantha J Brockmeyer, BA
525 Avon Belden Rd Ste 1,
Avon Lake, OH 44012-4101
Ph: (216) 302-7805 |
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