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Individual
SAMANTHA BIRTWELL
Active
Individual
SAMANTHA BIRTWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA,BA,LMFT
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1736
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008062567
—
CT
01
—
060669017
UBH-OXFORD HEALTH/FREEDOM/LIBERTY WELLMORE GRP/FACILITY
CT
01
—
060669107
ANTHEM BCBS OF CT WELLMORE GRP/FACILITY
CT
01
—
13584798
CAQH
CT
01
—
ACTIVE MEMBER
AAMFT
CT
01
—
D339123 141 E MAIN
VALUE OPTIONS
CT
01
—
PENDING
MHN-MANAGED HEALTH NETWORK
CT
Enumeration date
05/19/2014
Last updated
07/24/2020
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