Provider Demographics
NPI:1669206512
Name:BARGER, SAMANTHA A (MDIV, MS, LMHCA)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:A
Last Name:BARGER
Suffix:
Gender:F
Credentials:MDIV, MS, LMHCA
Other - Prefix:MISS
Other - First Name:SAMANTHA
Other - Middle Name:A
Other - Last Name:YANITY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:150 NICKERSON ST STE 204
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-1634
Mailing Address - Country:US
Mailing Address - Phone:206-537-0019
Mailing Address - Fax:
Practice Address - Street 1:150 NICKERSON ST STE 204
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-1634
Practice Address - Country:US
Practice Address - Phone:206-537-0019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61595615101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health