MEDICARE: SAMANTHA C WILKINSON

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	1041C0700X	Clinical Social Worker	094401	NY

General Provider Information

NPI Number	:	1417881848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA C WILKINSON

Provider Business Mailing Address
First Line	:	55 ETHELTON RD
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10603-2031
Country	:	US
Telephone Number	:	914-419-9640
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 ETHELTON RD
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10603-2031
Country	:	US
Telephone Number	:	914-419-9640
Fax Number	:

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

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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