Healthcare Provider Details

I. General information

NPI: 1669969374
Provider Name (Legal Business Name): SAMANTHA DANSBY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2018
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 RUCKER BLVD
ENTERPRISE AL
36330-2236
US

IV. Provider business mailing address

1210 RUCKER BLVD
ENTERPRISE AL
36330-3625
US

V. Phone/Fax

Practice location:
  • Phone: 334-370-4435
  • Fax:
Mailing address:
  • Phone: 334-370-4435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC04141
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: