Individual
AMANDA SAMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC, BS, CADAC II
Contact information
Practice address
7941 CASTLEWAY DR # IN, INDIANAPOLIS, IN 46250-1953
(317) 499-7192
Mailing address
7941 CASTLEWAY DR # IN, INDIANAPOLIS, IN 46250-1953
(317) 499-7192
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
86000452A
IN
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
04/08/2020
Last updated
08/23/2022
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