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Individual
NICOLE SIMONE SAMUELS
Active
Individual
NICOLE SIMONE SAMUELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
001526
CT
104100000X
Social Worker
105078
NY
1041C0700X
Clinical Social Worker
Primary
014306
CT
Other
Enumeration date
03/13/2019
Last updated
09/26/2024
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