MEDICARE: SAMANTHA GRACE CAHOONE MSW

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	CSW03249	RI

General Provider Information

NPI Number	:	1568151025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA GRACE CAHOONE MSW

Provider Business Mailing Address
First Line	:	65 VILLAGE SQUARE DR STE 302
Second Line	:
City	:	SOUTH KINGSTOWN
State	:	RI
Zip	:	02879-2569
Country	:	US
Telephone Number	:	401-785-0040
Fax Number	:

Provider Business Practice Location Address
First Line	:	91 FRANK AVE
Second Line	:
City	:	WEST KINGSTON
State	:	RI
Zip	:	02892-1428
Country	:	US
Telephone Number	:	401-868-7012
Fax Number	:

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

Provider Enumeration Date	:	05/02/2023
Last Update Date	:	02/05/2026

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