Healthcare Provider Details

I. General information

NPI: 1225711302
Provider Name (Legal Business Name): MS. SAMANTHA SCHAFFER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 EISENHOWER AVE STE 501
ALEXANDRIA VA
22314-4688
US

IV. Provider business mailing address

2121 EISENHOWER AVE STE 501
ALEXANDRIA VA
22314-4688
US

V. Phone/Fax

Practice location:
  • Phone: 540-845-6940
  • Fax: 484-842-6053
Mailing address:
  • Phone: 703-380-3345
  • Fax: 484-842-6053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701015500
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: