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General NPI Number Information
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NPI Number | 1497189484
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Entity Type | Individual
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Provider Name | CASSANDRA DEANNA SAMS LPC, LMHC
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Gender | Female
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Dates
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Enumeration Date | 08/26/2013
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Last Update Date | 04/01/2014
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Provider Practice Location Address
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Address Line | 3599 W LAKE MARY BLVD SUITE B
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City | LAKE MARY
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State | FL
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Zip | 32746-3417
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Country | US
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Telephone | 407-443-3371
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Fax |
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Provider Business Mailing Address
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Address Line | 2008 COURTYARD LOOP APT 204
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City | SANFORD
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State | FL
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Zip | 32771-7444
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Country | US
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Telephone | 407-322-8064
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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 | MH8571
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC004158
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License Number State | GA
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