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General NPI Number Information
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NPI Number | 1245687888
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Entity Type | Individual
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Provider Name | NATALIE SAMUELS
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Gender | Female
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Dates
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Enumeration Date | 05/24/2016
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Last Update Date | 04/22/2022
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Provider Practice Location Address
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Address Line | 6623 RUTH FERRELL CT
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City | CHARLOTTE
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State | NC
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Zip | 28269-2855
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Country | US
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Telephone | 203-667-3998
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Fax |
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Provider Business Mailing Address
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Address Line | 6623 RUTH FERRELL CT
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City | CHARLOTTE
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State | NC
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Zip | 28269-2855
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Country | US
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Telephone | 203-667-3998
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | A12192
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License Number State | NC
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