MEDICARE: SAMANTHA J ALLISON 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
1	101Y00000X	Counselor	74956	TX

General Provider Information

NPI Number	:	1538651286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA J ALLISON LPC

Provider Business Mailing Address
First Line	:	1584 SEMINOLE DR
Second Line	:
City	:	FORNEY
State	:	TX
Zip	:	75126-1450
Country	:	US
Telephone Number	:	501-658-3156
Fax Number	:

Provider Business Practice Location Address
First Line	:	1584 SEMINOLE DR
Second Line	:
City	:	FORNEY
State	:	TX
Zip	:	75126-1450
Country	:	US
Telephone Number	:	501-658-3156
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2018
Last Update Date	:	12/05/2025

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