SAMANTHA CLARK (NPI# 1366081036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366081036 |
| Entity Type | Individual |
| Full Name | SAMANTHA CLARK |
| Other Name | SAMANTHA STEVENS |
| Practice Address |
801 Hazen St Ste C Paw Paw MI 49079-2008 |
| Mailing Address |
Po Box 249 Paw Paw MI 49079-0249 |
| Practice Telephone | 2696553334 |
| Enumeration Date | 2019-12-30 |
| Last Update Date | 2019-12-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710593462 | Samantha Clark | Student in an Organized Health Care Education/Training Program | 182 Chickasaw Trl, Pontotoc, MS 38863-8857 | 2020-09-18 |
| 1285268177 | Samantha Fay Clark | Behavior Technician | 990d Klamath Ln, Yuba City, CA 95993-8961 | 2020-02-28 |
| 1225525298 | Samantha R Clark | Case Manager/Care Coordinator | Juneau County Dept. of Human Services, 200 Hickory Street, Mauston, WI 53948-2101 | 2018-04-16 |
| 1699186841 | Samantha Clark | Obstetrics & Gynecology | 224 W Exchange St Ste 420, Akron, OH 44302-1718 | 2014-05-09 |
| 1225636442 | Samantha Clark | Pharmacist | 3914 Capital Blvd, Raleigh, NC 27604-3412 | 2020-10-09 |
| 1902430630 | Samantha Clark | Behavior Technician | 1620 N Main St Ste 1, Walnut Creek, CA 94596-4653 | 2020-03-03 |
| 1144869900 | Samantha Jane Clark | Pharmacist | 330 Pine Tree Rd, Ithaca, NY 14850-2819 | 2019-12-26 |
| 1548816630 | Samantha Clark | Occupational Therapist | 1797 King Ave, Kings Mills, OH 45034-1721 | 2019-08-14 |
| 1871154443 | Samantha Jeanine Clark | Marriage & Family Therapist | 2621 Oswell St Ste 119, Bakersfield, CA 93306-3172 | 2019-06-25 |
| 1902460710 | Samantha Leigh Clark | Specialist | 9 Vose Farm Rd Ste 120, Peterborough, NH 03458-2154 | 2019-04-26 |
| Street Address |
801 HAZEN ST STE C |
| City | PAW PAW |
| State | MI |
| Zip Code | 49079-2008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982937199 | Eliezer Joseph | Counselor | 801 Hazen St Ste C, Paw Paw, MI 49079-2008 | 2009-09-08 |
| 1679108898 | Jacob Allen Wolfzorn | Counselor | 801 Hazen St Ste C, Paw Paw, MI 49079-2008 | 2020-03-09 |
| 1316578966 | Blaire Leeanne Phillips | Social Worker | 801 Hazen St Ste C, Paw Paw, MI 49079-2008 | 2020-02-03 |
| 1881234888 | Stephanie Williams | Counselor | 801 Hazen St Ste C, Paw Paw, MI 49079-2008 | 2020-01-08 |
| 1043786700 | Cindy Newberry | Social Worker | 801 Hazen St Ste C, Paw Paw, MI 49079-2008 | 2018-10-22 |
| 1902309602 | Pamela Baney | Social Worker | 801 Hazen St Ste C, Paw Paw, MI 49079-2008 | 2018-03-09 |
| 1336641422 | Michelle Olsen | Registered Nurse | 801 Hazen St Ste C, Paw Paw, MI 49079-2008 | 2018-03-05 |
| 1376058792 | Taylor Foco | Social Worker | 801 Hazen St Ste C, Paw Paw, MI 49079-2008 | 2017-12-07 |
| 1508371006 | Elizabeth Courtney | Social Worker | 801 Hazen St Ste C, Paw Paw, MI 49079-2008 | 2017-12-06 |
| 1942715677 | Lloyd Bloomer | Social Worker | 801 Hazen St Ste C, Paw Paw, MI 49079-2008 | 2017-12-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700359387 | Elizabeth Ann Heskett | Social Worker | Bronson Lakeview Family Care, 451 Health Parkway, Suite B, Paw Paw, MI 49079 | 2019-01-07 |
| 1346775269 | Timothy Adli Kanaan | Counselor | 816 E Michigan Ave Ste 103, Paw Paw, MI 49079 | 2017-04-28 |
| 1558655464 | Tamayi Bwititi | Family Medicine | 451 Health Pkwy Ste G, Paw Paw, MI 49079 | 2011-06-08 |
| 1942401047 | Jenny Adina Grunberg | Dentist | 54055 County Rd 653, Paw Paw, MI 49079 | 2007-05-29 |
| 1912058918 | David James Potts | Psychologist | 181 West Michigan Ave Suite 3, Mapleview Consultation Center P.c, Paw Paw, MI 49079 | 2007-01-16 |
| 1760438378 | Starhealth Multi-specialty Group, P.C. Pharmacy | Pharmacist | 451 Health Parkway, Paw Paw, MI 49079 | 2006-05-25 |
| 1528029568 | Jayantilal J Bathani | Pediatrics | 505 Hazen St, Ste 203, Paw Paw, MI 49079 | 2006-03-29 |
| 1548231202 | Gregory Cassidy | Physician Assistant | 125 N Kalamazoo St, #82, Paw Paw, MI 49079 | 2006-01-31 |
| 1649782418 | Amber Bemis | Occupational Therapy Assistant | 801 Hazen Street, Suite C, Paw Paw, MI 49079 | 2017-11-01 |
| 1073047122 | Theresa Arnold | Social Worker | 181 W Michigan Ave Ste 3, Paw Paw, MI 49079 | 2017-04-15 |
| Find all providers in zip 49079 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447851670 | Kendall Brocavich | Case Manager/Care Coordinator | 397 Blunk St, Plymouth, MI 48170-3752 | 2020-11-04 |
| 1932700242 | Best Choice Health Services, LLC | Case Manager/Care Coordinator | 19300 Greenfield Rd Ste C, Detroit, MI 48235-2003 | 2020-11-03 |
| 1871193557 | Pierce Reynolds | Case Manager/Care Coordinator | 160 E Cambourne St, Ferndale, MI 48220-1310 | 2020-10-30 |
| 1588262331 | Emmarose Malone Dwyer | Case Manager/Care Coordinator | 3843 Thomas Rd, Oxford, MI 48371-1556 | 2020-10-14 |
| 1861090953 | Jordan Johnson | Case Manager/Care Coordinator | 19710 Cherry Hill St, Southfield, MI 48076-1061 | 2020-10-12 |
| 1871191957 | Katrina M Dicesare | Case Manager/Care Coordinator | 39340 Medallion Ct Apt 7103, Farmington Hills, MI 48331-4913 | 2020-10-12 |
| 1144837618 | Lisa Glover | Case Manager/Care Coordinator | 1977 Radcliff Ave Se, Grand Rapids, MI 49506-5140 | 2020-09-28 |
| 1891301347 | Cierra C Coward | Case Manager/Care Coordinator | 20752 Camden Sq Apt 205, Southfield, MI 48076-3824 | 2020-09-21 |
| 1245845791 | Amanda Evanoff | Case Manager/Care Coordinator | 4619 Jerome Rd, Clarkston, MI 48346-3735 | 2020-09-11 |
| 1326653122 | Malika Triplett | Case Manager/Care Coordinator | 3002 Meisner Ave, Flint, MI 48506-2434 | 2020-09-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.