Healthcare Provider Details

I. General information

NPI: 1477350577
Provider Name (Legal Business Name): SAMANTHA NOWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2025
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 ROBINSON ST
POTTSTOWN PA
19464-6421
US

IV. Provider business mailing address

11 ROBINSON ST
POTTSTOWN PA
19464-6421
US

V. Phone/Fax

Practice location:
  • Phone: 484-941-0500
  • Fax:
Mailing address:
  • Phone: 484-941-0500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: