SAMANTHA MARIE LARSON MSW, LCSW
NPI 1740899285
Social Worker - Clinical in Sister Bay, WI

Active since July 30, 2020PECOS EnrolledAccepts Medicare Assignment
2345 CANTERBURY LN, SISTER BAY, WI 54234(920) 868-3511(608) 270-0467 Get Directions Write a Review

NPPES record last updated: January 16, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 16, 2026, Jun 20, 2023, Apr 11, 2023 and 1 more (4 updates tracked since 2020).

About Samantha Marie Larson Msw, Lcsw NPPES

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

SAMANTHA MARIE LARSON MSW, LCSW (NPI 1740899285) is an individual clinical provider in Sister Bay, Wisconsin, licensed in Wisconsin (11314-123) and active in the NPI registry since July 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1740899285
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSAMANTHA MARIE LARSONCredential: MSW, LCSW
Location Address2345 CANTERBURY LNSister Bay, WI 54234-5602
Mailing Address323 S 18th AveSturgeon Bay, WI 54235-1401
Fax(608) 270-0467
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJuly 30, 2020
Last NPPES UpdateJanuary 16, 20264 updates tracked since enumeration
NPPES CertifiedJanuary 16, 2026
NPI 1740899285 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in WI · 11314-123
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.
Also ListedSocial WorkerTaxonomy 104100000X · License 131979-121 (WI)
2345 CANTERBURY LN, Sister Bay, WI 54234

Other Names 1

Former Name (1)Samantha Prust

Accepted 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 Marie Larson Msw, 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 ID9032584438
PECOS Enrollment IDI20230701000436
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 54234 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 $53.90 – $163.24
Typical copayment $0.00 (range $13.47 – $40.81)
Most-billed visit code NA
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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 17

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

Occupational Therapist
2345 CANTERBURY LN
SISTER BAY, WI 54234
Podiatrist
2345 CANTERBURY LN
SISTER BAY, WI 54234
Nurse Practitioner
2345 CANTERBURY LN
SISTER BAY, WI 54234
Nurse Practitioner (Adult Health)
2345 CANTERBURY LN
SISTER BAY, WI 54234
Physical Therapist
2345 CANTERBURY LN
SISTER BAY, WI 54234
Physical Therapist
2345 CANTERBURY LN
SISTER BAY, WI 54234
Physical Therapist
2345 CANTERBURY LN
SISTER BAY, WI 54234
Physical Therapist
2345 CANTERBURY LN
SISTER BAY, WI 54234

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samantha Larson's NPI number?

The NPI number for Samantha Larson is 1740899285. It was assigned to this individual provider in the NPPES registry on July 30, 2020. The provider is also known as Samantha Prust.

Where is Samantha Larson located?

Samantha Larson practices at 2345 Canterbury Ln, Sister Bay, WI 54234. The listed phone number is (920) 868-3511.

What is Samantha Larson's specialty?

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

Is Samantha Larson enrolled in Medicare?

Yes. Samantha Larson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Samantha Larson accept?

Health plans from CareSource (Common Ground Healthcare), Medica, Network Health and Security Health Plan list Samantha Larson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samantha Larson was last updated on January 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.