SAMANTHA CLARK LCSW
NPI 1215505706
Social Worker - Clinical in Tampa, FL

Q: What is Samantha Clark's NPI number?

The NPI number for Samantha Clark is 1215505706. It was assigned to this individual provider in the NPPES registry on June 11, 2021.

Q: What is Samantha Clark's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Samantha Clark was last updated on May 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 11, 2021PECOS EnrolledAccepts Medicare Assignment

4918 N HABANA AVE, TAMPA, FL 33614(866) 762-1743(727) 816-1222 Get Directions Write a Review

NPPES record last updated: May 7, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 7, 2026, Mar 5, 2026, Jun 11, 2021 (3 updates tracked since 2021).

On this page

About Samantha Clark Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA CLARK LCSW (NPI 1215505706) is an individual clinical provider in Tampa, Florida, licensed in Florida (SW18383) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS and is a graduate of University Of South Florida College Of Medicine (2018).

NPPES Registry Identity

NPI1215505706

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameSAMANTHA CLARKCredential: LCSW

Location Address4918 N HABANA AVETampa, FL 33614-6815

Mailing Address2995 Drew St Fl 2Clearwater, FL 33759-3012 · (727) 532-0002

Phone(866) 762-1743

Fax(727) 816-1222

Sole ProprietorYes

Medical School CMSUniversity Of South Florida College Of MedicineGraduated 2018

Enumeration DateJune 11, 2021

Last NPPES UpdateMay 7, 20263 updates tracked since enumeration

NPPES CertifiedMay 7, 2026

✔ NPI 1215505706 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in FL · SW18383

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.

4918 N HABANA AVE, Tampa, FL 33614

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Samantha Clark Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4385085380

PECOS Enrollment IDI20240508001777

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33614 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $56.00 – $171.84

Typical copayment $0.00 (range $14.00 – $42.96)

Most-billed visit code NA

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARILYN PARADOA

Psychologist