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NPI Code Detail

MEDICARE: SAMANTHA FERNATT LPC

MEDICARE: SAMANTHA FERNATT LPC
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
1101YP2500XProfessional Counselor0701012352VA

General Provider Information

NPI Number : 1184301665
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA FERNATT LPC
Provider Business Mailing Address
First Line : PO BOX 254
Second Line :
City : DALEVILLE
State : VA
Zip : 24083-0254
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3635 MANASSAS DR STE A
Second Line :
City : ROANOKE
State : VA
Zip : 24018-4031
Country : US
Telephone Number : 540-774-4686
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2023
Last Update Date : 05/26/2026

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Directions to “ SAMANTHA FERNATT LPC” Practice Location

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