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General NPI Number Information
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NPI Number | 1801234190
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Entity Type | Individual
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Provider Name | SAMANTHA H JOSEPH LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/07/2013
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Last Update Date | 12/03/2020
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Provider Practice Location Address
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Address Line | 319 S NAPERVILLE RD STE 203
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City | WHEATON
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State | IL
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Zip | 60187-5462
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Country | US
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Telephone | 847-804-7393
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Fax |
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Provider Business Mailing Address
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Address Line | 797 DANNET RD UNIT 2B
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-1174
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Country | US
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Telephone | 847-804-7393
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149015993
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License Number State | IL
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