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General NPI Number Information
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NPI Number | 1962096719
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Entity Type | Individual
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Provider Name | SAMANTHA CHADWELL
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Gender | Female
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Dates
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Enumeration Date | 02/23/2021
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 14837 DETROIT AVE # 193
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City | LAKEWOOD
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State | OH
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Zip | 44107-3909
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Country | US
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Telephone | 216-270-2904
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Fax | 888-684-5911
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Provider Business Mailing Address
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Address Line | 25 MEADOW ST
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City | BUCKHANNON
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State | WV
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Zip | 26201-2246
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Country | US
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Telephone | 419-787-7424
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | OH
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