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General NPI Number Information
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NPI Number | 1093286163
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Entity Type | Individual
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Provider Name | TERRI LOREN SAMUELS LMHC
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Gender | Female
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Dates
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Enumeration Date | 12/16/2018
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 4600 LINTON BLVD STE 250
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City | DELRAY BEACH
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State | FL
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Zip | 33445-6600
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Country | US
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Telephone | 561-496-1094
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Fax |
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Provider Business Mailing Address
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Address Line | 190 SE 5TH AVE APT 322
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City | DELRAY BEACH
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State | FL
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Zip | 33483-5233
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Country | US
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Telephone | 561-271-5656
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH16574
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License Number State | FL
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