MS. TRISTA SAMUELSON


Address: 4510 Frankford Ave, 2nd Floor, Philadelphia, PA 19124-3602
Phone: 2158319882

MS. TRISTA SAMUELSON (NPI# 1932359668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1932359668
Entity Type Individual
Full Name MS. TRISTA SAMUELSON
Credential LCSW
Practice Address 4510 Frankford Ave
2nd Floor
Philadelphia
PA 19124-3602
Mailing Address 432 N 6th St
Philadelphia
PA 19123-4004
Practice Telephone 2158319882
Practice Fax Number 2158319887
Mailing Telephone 2159252400
Mailing Fax Number 2159259162
Enumeration Date 2008-09-30
Last Update Date 2011-04-19
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1041C0700X Social Worker
Specialization: Clinical
CW016916 PA Behavioral Health & Social Service Providers
N 1041C0700X Social Worker
Specialization: Clinical
006823 CT Behavioral Health & Social Service Providers

Office Location

Street Address 4510 FRANKFORD AVE
2ND FLOOR
City PHILADELPHIA
State PA
Zip Code 19124-3602

Providers in the same location

NPI Name Taxonomy Address Enumeration
1821064015 Andrew R Quint Internal Medicine 4510 Frankford Ave, Philadelphia, PA 19124-3602 2006-02-27
1922650415 Johnnie C Young Sr. Counselor 4510 Frankford Ave, Philadelphia, PA 19124-3602 2019-07-15
1265098768 Katherine Ierardi Registered Nurse 4510 Frankford Ave, Philadelphia, PA 19124 2019-05-10
1306319504 Christopher Aguilar Registered Nurse 4510 Frankford Ave, Philadelphia, PA 19124-3602 2019-01-10
1831661362 Kevin Williams Jr. Counselor 4510 Frankford Ave, Philadelphia, PA 19124-3602 2018-12-21
1508334186 Danielle Mangiaracina Counselor 4510 Frankford Ave, Philadelphia, PA 19124-3602 2018-11-13
1518442086 Christine J Kim Dentist 4510 Frankford Ave, Philadelphia, PA 19124 2018-10-01
1770080160 Tiffany Filomena Interra Counselor 4510 Frankford Ave, Philadelphia, PA 19124-3602 2018-04-11
1770019481 Patricia Richardson Counselor 4510 Frankford Ave, 2nd Floor, Philadelphia, PA 19124-3602 2017-05-02
1912447533 Tiffany Reid Nurse Practitioner 4510 Frankford Ave, Philadelphia, PA 19124-3602 2017-03-01
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1831749308 William Mark Hanna Sr. Pharmacist 4600 Rooselvelt Blvd Bldg G, Philadelphia, PA 19124 2019-09-17
1881256451 Medical Discovery Systems, LLC Durable Medical Equipment & Medical Supplies 5425 Oxford Ave., 5425 Oxford Ave. Suite (3 A), Philadelphia, PA 19124 2019-07-03
1548731391 Sierra Pinkney Registered Nurse 1615 Granite St, Philadelphia, PA 19124 2018-12-05
1922507987 Xavier Sergio Henriquez Counselor 4510 Frankford Avenue 2nd Floor, Philadelphia, PA 19124 2018-02-06
1558881581 Isabel Cristina Castillo Hernandez Pediatrics 4500-10, Apt 201b, Philadelphia, PA 19124 2017-06-21
1952843732 Patrick Grugan Social Worker Roosevelt Boulevard & Adams Avenue, Philadelphia, PA 19124 2016-11-10
1811340482 Katarzyna Liwski Psychiatry & Neurology 4641 Roosevelt Boulevard, E212, Drexel University College of Medicine Friends Hospital, Philadelphia, PA 19124 2016-07-19
1851769327 Aleka Kostouros Social Worker Roosevelt Blvd & Adams Ave, Northeast Community Center for Behavioral Health, Philadelphia, PA 19124 2015-09-14
1407230378 Sara Bachani Psychiatry & Neurology 4641 Roosevelt Blvd, Friends Hospital, Room 231, Philadelphia, PA 19124 2015-07-10
1215327051 Alyssa Renee Kirk Counselor 4500-10 Frankford Ave, 2nd Floor, Philadelphia, PA 19124 2015-02-02
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Taxonomy Information

Taxonomy Code 1041C0700X
Grouping Behavioral Health & Social Service Providers
Classification Social Worker
Specialization Clinical

Taxonomy Definition

A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1215538657 Noel Mitchell Social Worker 410 Memphis St, Philadelphia, PA 19125-2642 2020-11-03
1326649963 Sarah Michelle Waxman Social Worker 2550 Grays Ferry Ave, Philadelphia, PA 19146-2331 2020-11-02
1467051540 Maya Cox Social Worker 4045 Green St, Philadelphia, PA 19104-1759 2020-10-20
1679170575 Wendy Diane Nickerson Social Worker 741 S 2nd St, Philadelphia, PA 19147-3425 2020-10-04
1497362404 Lora M Rhodes Social Worker 925 Chestnut St Ste 321a, Philadelphia, PA 19107-4216 2020-09-24
1841806395 Molly Vocino Social Worker 925 Chestnut St Ste 422u, Philadelphia, PA 19107-4216 2020-09-21
1306452065 Rebecca Cammy Social Worker 925 Chestnut St # 422w, Philadelphia, PA 19107-4216 2020-09-18
1598378663 Suzanne Banning Anderson Social Worker Sayre High School, 5800 Walnut St, Philadelphia, PA 19139 2020-08-28
1265045272 Lisa Gabrielle Schilansky Social Worker 4813 Springfield Ave Apt 1, Philadelphia, PA 19143-3409 2020-08-28
1962015537 Joanna Elizabeth Vanore Social Worker 4725 Sheldon St, Philadelphia, PA 19127-1008 2020-08-24
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Competitor

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City PHILADELPHIA
Zip Code 19124

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Dataset Information

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.

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