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Individual

SAMANTHA VAN SICKLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
191 LAMAR HALEY PKWY, CANTON, GA 30114-8019
(470) 979-0049
Mailing address
206 NORTHBROOKE CT, WOODSTOCK, GA 30188-2195

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC016380
GA

Other

Enumeration date
04/14/2026
Last updated
04/14/2026
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