Healthcare Provider Details

I. General information

NPI: 1619624129
Provider Name (Legal Business Name): SAMANTHA ORDOVER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2022
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 WILLIAMS ST STE 210
CHATTANOOGA TN
37408-1190
US

IV. Provider business mailing address

1401 WILLIAMS ST STE 210
CHATTANOOGA TN
37408-1190
US

V. Phone/Fax

Practice location:
  • Phone: 423-584-3607
  • Fax:
Mailing address:
  • Phone: 877-258-8795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10318
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW19239
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: