Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Samantha Clark, LICSW

Individual provider Social Worker · NPI 1477214898

MS. Samantha Clark, LICSW is a Clinical Social Worker in Bridgeport, West Virginia. Qualified in 2020, 6 years ago. Practices with Grandw Inc, a 90-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Pennsylvania and West Virginia.

Years since qualifying
6
Licensed in
PA, WV
In the registry since
2022
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

120 Professional Pl Ste 101
Bridgeport, WV 26330-4599
Phone: (304) 513-3495
Fax: (800) 734-8498
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 14 E Grafton Rd Ste C, Fairmont, WV 26554-4465 — (304) 366-5832

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence DP00946604 (WV)
Social Worker Taxonomy 104100000X · Licence 138525 (PA)

Record details

NPI number1477214898
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorYes
NPI enumeratedJanuary 7, 2022
Last updated in NPPESApril 9, 2026
Certification dateApril 9, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Grandw Inc — 90 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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