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General NPI Number Information
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NPI Number | 1942993738
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Entity Type | Organization
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Legal Business Name | SAMSKARA COUNSELING LCSW PLLC
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Dates
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Enumeration Date | 05/30/2023
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 6 AUTOMATION LN STE 107
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City | ALBANY
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State | NY
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Zip | 12205-1658
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Country | US
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Telephone | 518-328-4741
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Fax |
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Provider Business Mailing Address
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Address Line | 4411 NY HIGHWAY 150
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City | WEST SAND LAKE
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State | NY
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Zip | 12196-1921
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Country | US
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Telephone | 518-577-9556
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAUREN JACOBS
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Credential | LCSWR
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Telephone | 518-577-9556
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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 |
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License Number State |
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