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General NPI Number Information
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NPI Number | 1659014959
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Entity Type | Individual
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Provider Name | SAMANTHA BALDUCCI MA, LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 04/15/2022
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 4 PRINCESS RD STE 206
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2322
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Country | US
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Telephone | 609-482-3701
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Fax |
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Provider Business Mailing Address
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Address Line | 4 PRINCESS RD STE 206
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2322
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Country | US
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Telephone | 609-482-3701
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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 | 37PC01056800
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License Number State | NJ
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