Individual
SAMANTHA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
650 FULTON ST, BROOKLYN, NY 11217-1517
(718) 596-9800
Mailing address
131 W 112TH ST APT 1A, NEW YORK, NY 10026-3702
(347) 608-9308
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13286
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13286
CASAC-2
NY
Enumeration date
04/29/2019
Last updated
04/29/2019
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