Provider Demographics
NPI:1023652732
Name:SAMPSON, SETH ALLEN (PHD, LPC , NCC,CSC)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:ALLEN
Last Name:SAMPSON
Suffix:
Gender:M
Credentials:PHD, LPC , NCC,CSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8627 CINNAMON CREEK DR STE 601
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1482
Mailing Address - Country:US
Mailing Address - Phone:210-772-0071
Mailing Address - Fax:
Practice Address - Street 1:8627 CINNAMON CREEK DR STE 601
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1482
Practice Address - Country:US
Practice Address - Phone:210-772-0071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YS0200X
TX78136101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1245999879OtherBLUE CROSS BLUE SHIELD
TX1245999879OtherAETNA
TX1245999879OtherCIGNA
TX1245999879OtherANTHEM
TX1245999879OtherUNITED HEALTH CARE
TX1245999879OtherEVERNORTH