Healthcare Provider Details

I. General information

NPI: 1952165409
Provider Name (Legal Business Name): SAMANTHA STAHL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2024
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6425 LIVING PL STE 200
PITTSBURGH PA
15206-5122
US

IV. Provider business mailing address

6425 LIVING PL STE 200
PITTSBURGH PA
15206-5122
US

V. Phone/Fax

Practice location:
  • Phone: 410-343-9237
  • Fax:
Mailing address:
  • Phone: 410-343-9237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPC002391
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: