MEDICARE: SAMANTHA ESPINOSA LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	15644	FL
2	1041C0700X	Clinical Social Worker	15644	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386092302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA ESPINOSA LCSW

Provider Business Mailing Address
First Line	:	2507 CALLAWAY RD
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32303-5267
Country	:	US
Telephone Number	:	850-644-6543
Fax Number	:

Provider Business Practice Location Address
First Line	:	2507 CALLAWAY RD
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32303-5267
Country	:	US
Telephone Number	:	850-644-6543
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2016
Last Update Date	:	03/13/2024

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Directions to “ SAMANTHA ESPINOSA LCSW” Practice Location

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