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MRS. SAMANTHA BROOKE JEFFERSON LCSW-C NPI 1033750773


NPI Information

NPI: 1033750773
Provider Name: MRS. SAMANTHA BROOKE JEFFERSON, LCSW-C
Classification: Social Worker - 104100000X
Entity Type: Individual

PECOS Registration: Yes

Address:
5807 HARFORD RD
BALTIMORE, MD
ZIP 21214
Phone: (410) 444-2100
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MRS. Samantha Brooke Jefferson, LCSW-C is a social worker in Baltimore, MD. The provider is a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. MRS. Samantha Brooke Jefferson, LCSW-C NPI is 1033750773. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5807 HARFORD RD
BALTIMORE, MD
ZIP 21214-895
Phone: (410) 444-2100
Fax: (410) 426-1140

The NPI 1033750773 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 10/3/2019 and was last updated on 10/3/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YA0400XCounselorAddiction (Substance Use Disorder)934MARYLANDNo
21041C0700XSocial WorkerClinical173371MARYLANDNo
31041S0200XSocial WorkerSchool173371MARYLANDNo
4104100000XSocial Worker173371MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000000MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.