Individual
SAMANTHA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
112B BYPASS 225, GREENWOOD, SC 29646-1154
(864) 936-6910
Mailing address
112B BYPASS 225, GREENWOOD, SC 29646-1154
(864) 936-6910
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6294
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6294
LICENSED PROFESSIONAL COUNSELOR
SC
Enumeration date
08/08/2014
Last updated
07/20/2020
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