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DR. SAMANTHA DEWITT WILSON PSYD, LCSW
NPI 1881823045
Clinical Neuropsychologist in San Diego, CA

Active since July 09, 2009PECOS EnrolledAccepts Medicare Assignment
10085 CARROLL CANYON RD STE 200H, SAN DIEGO, CA 92131(858) 208-3463 Get Directions Write a Review

NPPES record last updated: November 4, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 4, 2024, Sep 10, 2024, Oct 3, 2023 and 1 more (4 updates tracked since 2018).

About Dr. Samantha Dewitt Wilson Psyd, Lcsw NPPES

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

DR. SAMANTHA DEWITT WILSON PSYD, LCSW (NPI 1881823045) is an individual clinical neuropsychologist in San Diego, California, licensed in California (PSY34430) and active in the NPI registry since July 2009. She is enrolled in Medicare PECOS, maintains a secondary practice location in Carlsbad, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1881823045
Entity TypeIndividualFemale
Primary Taxonomy103G00000X
Provider Legal NameDR. SAMANTHA DEWITT WILSONCredential: PSYD, LCSW
Location Address10085 CARROLL CANYON RD STE 200HSan Diego, CA 92131-1100
Mailing Address10085 Carroll Canyon Rd Ste 200hSan Diego, CA 92131-1100 · (858) 208-3463
Phone(858) 208-3463
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateJuly 9, 2009
Last NPPES UpdateNovember 4, 20244 updates tracked since enumeration
NPPES CertifiedNovember 4, 2024
✔ NPI 1881823045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License✔ Licensed in CA · PSY34430
Definition
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
Also ListedPsychologistTaxonomy 103T00000X · License 34430 (CA)
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 76389 (CA)
10085 CARROLL CANYON RD STE 200H, San Diego, CA 92131
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Secondary Practice Location 1

Location 1785 Grand Ave Ste 212Carlsbad, CA 92008-2371 · Phone (760) 453-7175

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Samantha Dewitt Wilson Psyd, 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 ID4284090887
PECOS Enrollment IDI20231116001119
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.

Medicare Billing Reassignment

Medicare enrollment records show Samantha Wilson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Adr Wellness A Professional Psychology Corporation
23 mi
Psychiatry
785 GRAND AVE STE 101
Carlsbad, CA 92008
  • Reassigned Medicare billing, California enrollment
  • 15 clinicians in this Medicare group
NPI 1073028742 (760) 793-8063

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

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

NEUROEVOLVE INTEGRATIVE HEALTH, A PROFESSIONAL PSYCHOLOGY CORPORATION
Clinical Neuropsychologist
10085 CARROLL CANYON RD STE 200H
SAN DIEGO, CA 92131
San Diego County (858) 208-3463

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 Wilson's NPI number?

The NPI number for Samantha Wilson is 1881823045. It was assigned to this individual provider in the NPPES registry on July 9, 2009.

Where is Samantha Wilson located?

Samantha Wilson practices at 10085 Carroll Canyon Rd Ste 200H, San Diego, CA 92131. The listed phone number is (858) 208-3463.

What is Samantha Wilson's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Samantha Wilson enrolled in Medicare?

Yes. Samantha Wilson 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.

Which organization bills Medicare for Samantha Wilson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Samantha Wilson reassigns Medicare benefits to Adr Wellness A Professional Psychology Corporation (Carlsbad, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Samantha Wilson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Samantha Wilson was last updated on November 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.