MS. TRISTA SAMUELSON (NPI# 1932359668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932359668 |
| Entity Type | Individual |
| Full Name | MS. TRISTA SAMUELSON |
| Credential | LCSW |
| Practice Address |
4510 Frankford Ave 2nd Floor Philadelphia PA 19124-3602 |
| Mailing Address |
432 N 6th St Philadelphia PA 19123-4004 |
| Practice Telephone | 2158319882 |
| Practice Fax Number | 2158319887 |
| Mailing Telephone | 2159252400 |
| Mailing Fax Number | 2159259162 |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2011-04-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
CW016916 | PA | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
006823 | CT | Behavioral Health & Social Service Providers |
| Street Address |
4510 FRANKFORD AVE 2ND FLOOR |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19124-3602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821064015 | Andrew R Quint | Internal Medicine | 4510 Frankford Ave, Philadelphia, PA 19124-3602 | 2006-02-27 |
| 1922650415 | Johnnie C Young Sr. | Counselor | 4510 Frankford Ave, Philadelphia, PA 19124-3602 | 2019-07-15 |
| 1265098768 | Katherine Ierardi | Registered Nurse | 4510 Frankford Ave, Philadelphia, PA 19124 | 2019-05-10 |
| 1306319504 | Christopher Aguilar | Registered Nurse | 4510 Frankford Ave, Philadelphia, PA 19124-3602 | 2019-01-10 |
| 1831661362 | Kevin Williams Jr. | Counselor | 4510 Frankford Ave, Philadelphia, PA 19124-3602 | 2018-12-21 |
| 1508334186 | Danielle Mangiaracina | Counselor | 4510 Frankford Ave, Philadelphia, PA 19124-3602 | 2018-11-13 |
| 1518442086 | Christine J Kim | Dentist | 4510 Frankford Ave, Philadelphia, PA 19124 | 2018-10-01 |
| 1770080160 | Tiffany Filomena Interra | Counselor | 4510 Frankford Ave, Philadelphia, PA 19124-3602 | 2018-04-11 |
| 1770019481 | Patricia Richardson | Counselor | 4510 Frankford Ave, 2nd Floor, Philadelphia, PA 19124-3602 | 2017-05-02 |
| 1912447533 | Tiffany Reid | Nurse Practitioner | 4510 Frankford Ave, Philadelphia, PA 19124-3602 | 2017-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831749308 | William Mark Hanna Sr. | Pharmacist | 4600 Rooselvelt Blvd Bldg G, Philadelphia, PA 19124 | 2019-09-17 |
| 1881256451 | Medical Discovery Systems, LLC | Durable Medical Equipment & Medical Supplies | 5425 Oxford Ave., 5425 Oxford Ave. Suite (3 A), Philadelphia, PA 19124 | 2019-07-03 |
| 1548731391 | Sierra Pinkney | Registered Nurse | 1615 Granite St, Philadelphia, PA 19124 | 2018-12-05 |
| 1922507987 | Xavier Sergio Henriquez | Counselor | 4510 Frankford Avenue 2nd Floor, Philadelphia, PA 19124 | 2018-02-06 |
| 1558881581 | Isabel Cristina Castillo Hernandez | Pediatrics | 4500-10, Apt 201b, Philadelphia, PA 19124 | 2017-06-21 |
| 1952843732 | Patrick Grugan | Social Worker | Roosevelt Boulevard & Adams Avenue, Philadelphia, PA 19124 | 2016-11-10 |
| 1811340482 | Katarzyna Liwski | Psychiatry & Neurology | 4641 Roosevelt Boulevard, E212, Drexel University College of Medicine Friends Hospital, Philadelphia, PA 19124 | 2016-07-19 |
| 1851769327 | Aleka Kostouros | Social Worker | Roosevelt Blvd & Adams Ave, Northeast Community Center for Behavioral Health, Philadelphia, PA 19124 | 2015-09-14 |
| 1407230378 | Sara Bachani | Psychiatry & Neurology | 4641 Roosevelt Blvd, Friends Hospital, Room 231, Philadelphia, PA 19124 | 2015-07-10 |
| 1215327051 | Alyssa Renee Kirk | Counselor | 4500-10 Frankford Ave, 2nd Floor, Philadelphia, PA 19124 | 2015-02-02 |
| Find all providers in zip 19124 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538657 | Noel Mitchell | Social Worker | 410 Memphis St, Philadelphia, PA 19125-2642 | 2020-11-03 |
| 1326649963 | Sarah Michelle Waxman | Social Worker | 2550 Grays Ferry Ave, Philadelphia, PA 19146-2331 | 2020-11-02 |
| 1467051540 | Maya Cox | Social Worker | 4045 Green St, Philadelphia, PA 19104-1759 | 2020-10-20 |
| 1679170575 | Wendy Diane Nickerson | Social Worker | 741 S 2nd St, Philadelphia, PA 19147-3425 | 2020-10-04 |
| 1497362404 | Lora M Rhodes | Social Worker | 925 Chestnut St Ste 321a, Philadelphia, PA 19107-4216 | 2020-09-24 |
| 1841806395 | Molly Vocino | Social Worker | 925 Chestnut St Ste 422u, Philadelphia, PA 19107-4216 | 2020-09-21 |
| 1306452065 | Rebecca Cammy | Social Worker | 925 Chestnut St # 422w, Philadelphia, PA 19107-4216 | 2020-09-18 |
| 1598378663 | Suzanne Banning Anderson | Social Worker | Sayre High School, 5800 Walnut St, Philadelphia, PA 19139 | 2020-08-28 |
| 1265045272 | Lisa Gabrielle Schilansky | Social Worker | 4813 Springfield Ave Apt 1, Philadelphia, PA 19143-3409 | 2020-08-28 |
| 1962015537 | Joanna Elizabeth Vanore | Social Worker | 4725 Sheldon St, Philadelphia, PA 19127-1008 | 2020-08-24 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19124 |
Please comment or provide details below to improve the information on MS. TRISTA SAMUELSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.