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General NPI Number Information
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NPI Number | 1548446479
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Entity Type | Organization
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Legal Business Name | GLORIA SAMANSKY, LCSW, INC.
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 01/09/2008
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Provider Practice Location Address
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Address Line | 416 E 86TH AVE
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City | MERRILLVILLE
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State | IN
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Zip | 46410-6211
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Country | US
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Telephone | 219-309-5898
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Fax |
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Provider Business Mailing Address
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Address Line | 416 E 86TH AVE
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City | MERRILLVILLE
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State | IN
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Zip | 46410-6211
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Country | US
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Telephone | 219-309-5898
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GLORIA SAMANSKY
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Credential | LCSW
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Telephone | 219-309-5898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34005419A
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License Number State | IN
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