Samantha Clark, LICSW
NPI 1477214898ActiveIndividual· Social Worker· Bridgeport, WV
Social Worker (LICSW) with Grandw Inc, practicing in Bridgeport, West Virginia. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1477214898 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LICSW |
| Sole proprietor | Yes |
| NPI issued | Jan 7, 2022 |
| Last updated in NPPES | Apr 9, 2026 |
| Certified by provider | Apr 9, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker Primary | 104100000X | DP00946604 | WV |
| Social Worker | 104100000X | 138525 | PA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (WV) |
|---|
Education and affiliations
| Graduation year | 2020 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical group
- Grandw IncMorgantown, WV · 95 clinicians
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