MEDICARE: ANGELA M SAMSON LPCA

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
1	101Y00000X	Counselor	127767	KY

General Provider Information

NPI Number	:	1760379044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA M SAMSON LPCA

Provider Business Mailing Address
First Line	:	115 E PUBLIC SQ STE A
Second Line	:
City	:	SCOTTSVILLE
State	:	KY
Zip	:	42164-1440
Country	:	US
Telephone Number	:	270-943-7818
Fax Number	:	270-943-7818

Provider Business Practice Location Address
First Line	:	115 E PUBLIC SQ STE A
Second Line	:
City	:	SCOTTSVILLE
State	:	KY
Zip	:	42164-1440
Country	:	US
Telephone Number	:	270-943-7818
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2025
Last Update Date	:	06/19/2025

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