Healthcare Provider Details
I. General information
NPI: 1710457569
Provider Name (Legal Business Name): SAMANTHA VANBUSKIRK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/04/2018
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1803 OREGON PIKE
LANCASTER PA
17601-6401
US
IV. Provider business mailing address
400 POND VISTA LN APT I
MANHEIM PA
17545-9818
US
V. Phone/Fax
- Phone: 717-560-9969
- Fax:
- Phone: 302-668-6879
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | CW022935 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: