Healthcare Provider Details

I. General information

NPI: 1265354427
Provider Name (Legal Business Name): SAMANTHA NICOLE INTROCASO LPC, LPCMH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2611 BARDELL DR
WILMINGTON DE
19808-3023
US

IV. Provider business mailing address

2611 BARDELL DR
WILMINGTON DE
19808-3023
US

V. Phone/Fax

Practice location:
  • Phone: 302-229-8388
  • Fax:
Mailing address:
  • Phone: 302-229-8388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC-017296
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC-0011715
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: