Healthcare Provider Details

I. General information

NPI: 1538011937
Provider Name (Legal Business Name): SAMANTHA LEHERT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3328 FRANKLIN AVE
MILLBROOK NY
12545-5969
US

IV. Provider business mailing address

3328 FRANKLIN AVE
MILLBROOK NY
12545-5969
US

V. Phone/Fax

Practice location:
  • Phone: 845-335-5615
  • Fax:
Mailing address:
  • Phone: 845-335-5615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP133789
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: