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NPI Code Detail

MEDICARE: SAMANTHA HEATH MSW

MEDICARE: SAMANTHA HEATH MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorC012993NC
21041C0700XClinical Social WorkerC012993NC

General Provider Information

NPI Number : 1295288207
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA HEATH MSW
Provider Business Mailing Address
First Line : 408 E 11TH ST
Second Line :
City : WASHINGTON
State : NC
Zip : 27889-3719
Country : US
Telephone Number : 252-975-2027
Fax Number :
Provider Business Practice Location Address
First Line : 408 E 11TH ST
Second Line :
City : WASHINGTON
State : NC
Zip : 27889-3719
Country : US
Telephone Number : 252-975-2027
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2016
Last Update Date : 09/12/2023

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