Individual provider · Type 1 NPI

Samantha Ross, LCSW

Clinical Social Worker · Crestline, CA

NPI number 1114808797 Active

Practice location

1137 Jupiter Way
Crestline, CA 92325-9424

Mailing address

PO Box 728
Crestline, CA 92325-0728

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X122545 (CA)

Clinical Social Worker: 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 interpers…

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About NPI 1114808797

Samantha Ross, LCSW's National Provider Identifier is 1114808797, issued on Sep 10, 2025. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Crestline, CA. The record was last updated on Sep 10, 2025.