Samantha Dale, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Sayville, New York. Her current practice location is
21 Nancy Dr, Sayville, New York. You can reach out to her office (for appointments etc.) via phone at
(631) 942-7447.
Samantha Dale is licensed to practice in New York (license number 090337) 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 1205462231.
Healthcare Provider's Profile
Full Name | Samantha Dale |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 21 Nancy Dr, Sayville, New York |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1205462231
- Provider Enumeration Date: 03/21/2020
- Last Update Date: 06/05/2023
Medicare PECOS Information:
- PECOS PAC ID: 2264887199
- Enrollment ID: I20231013000150
Medical Identifiers
Medical identifiers for Samantha Dale such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1205462231 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | 090337 (New York) | 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 Dale allows following entities to bill medicare on her behalf.
Entity Name | Che Senior Psychological Services, Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1023078219 PECOS PAC ID: 8022905314 Enrollment ID: O20040322001429 |
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Entity Name | Psychological Health Services Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1043248776 PECOS PAC ID: 1153212998 Enrollment ID: O20040322001760 |
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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 Dale 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 Dale, LCSW 147 Rosebud Ct, Patchogue, NY 11772-4180 Ph: () - | Samantha Dale, LCSW 21 Nancy Dr, Sayville, NY 11782-2914 Ph: (631) 942-7447 |
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