Healthcare Provider Details

I. General information

NPI: 1003405309
Provider Name (Legal Business Name): SAMANTHA CIAMBRO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 10/16/2022
Certification Date: 10/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8050 BECKETT CENTER DR STE 105
WEST CHESTER OH
45069-5019
US

IV. Provider business mailing address

8050 BECKETT CENTER DR STE 105
WEST CHESTER OH
45069-5019
US

V. Phone/Fax

Practice location:
  • Phone: 513-463-1804
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA CIAMBRO
Title or Position: PSYCHOTHERAPIST
Credential: MS, LPC, NCC
Phone: 513-335-0006