Healthcare Provider Details

I. General information

NPI: 1871466656
Provider Name (Legal Business Name): ASHERAH IANSA SAMADI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 N CLAYTON ST
WILMINGTON DE
19805-3141
US

IV. Provider business mailing address

3911 CONCORD PIKE # 84630
WILMINGTON DE
19803-1736
US

V. Phone/Fax

Practice location:
  • Phone: 609-234-7819
  • Fax:
Mailing address:
  • Phone: 609-234-7819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: