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General NPI Number Information
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NPI Number | 1528640653
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Entity Type | Individual
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Provider Name | SAMANTHA SHERWOOD PHD
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Gender | Female
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Dates
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Enumeration Date | 04/27/2021
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 9205 W RUSSELL RD BLDG 3, STE 240
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City | LAS VEGAS
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State | NV
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Zip | 89148
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Country | US
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Telephone | 702-323-8355
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Fax |
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Provider Business Mailing Address
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Address Line | 9205 W RUSSELL RD BLDG 3, STE 240
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City | LAS VEGAS
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State | NV
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Zip | 89148
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Country | US
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Telephone | 702-323-8355
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY1162
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PY1162
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License Number State | NV
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