Provider Demographics
NPI:1144183377
Name:YU, SAMANTHA L (CSW)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:L
Last Name:YU
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:SAM L.
Other - Middle Name:
Other - Last Name:YU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:455 TOLL GATE RD
Mailing Address - Street 2:PRC AND CREDENTIALING
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2759
Mailing Address - Country:US
Mailing Address - Phone:401-273-0641
Mailing Address - Fax:401-273-2919
Practice Address - Street 1:171 SERVICE AVE FL 1
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1014
Practice Address - Country:US
Practice Address - Phone:401-430-2000
Practice Address - Fax:401-453-7597
Is Sole Proprietor?:No
Enumeration Date:2025-12-04
Last Update Date:2025-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW037341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical