Healthcare Provider Details

I. General information

NPI: 1891626305
Provider Name (Legal Business Name): MRS. SAMANTHA CHRISTINE LAWRENCE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

256 WASHINGTON ST
MOUNT VERNON NY
10553-1052
US

IV. Provider business mailing address

4234 BOYD AVE
BRONX NY
10466-2004
US

V. Phone/Fax

Practice location:
  • Phone: 914-613-0700
  • Fax:
Mailing address:
  • Phone: 347-202-3614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: