Healthcare Provider Details

I. General information

NPI: 1336068956
Provider Name (Legal Business Name): SAMANTHA LEE PHD, LMHC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 MYERS CORNERS RD
WAPPINGERS FALLS NY
12590-2142
US

IV. Provider business mailing address

3 LITTLE RD
WAPPINGERS FALLS NY
12590-3649
US

V. Phone/Fax

Practice location:
  • Phone: 845-262-0460
  • Fax:
Mailing address:
  • Phone: 914-953-9330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number018080
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: