Healthcare Provider Details

I. General information

NPI: 1417014713
Provider Name (Legal Business Name): MARGARET FRIEDA SAMUELS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 W CHAPEL HILL ST SUITE 908
DURHAM NC
27701-3616
US

IV. Provider business mailing address

411 W CHAPEL HILL ST SUITE 908
DURHAM NC
27701-3616
US

V. Phone/Fax

Practice location:
  • Phone: 919-419-3474
  • Fax: 919-419-9353
Mailing address:
  • Phone: 919-419-3474
  • Fax: 919-419-9353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0701211
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: