Provider Demographics
NPI:1942777263
Name:FOULKROD, SAMANTHA (MED, LPC-S)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:FOULKROD
Suffix:
Gender:F
Credentials:MED, LPC-S
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:FORDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:8102 FRY RD STE A
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-7077
Mailing Address - Country:US
Mailing Address - Phone:832-725-7619
Mailing Address - Fax:
Practice Address - Street 1:12915 DEER COVE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-4274
Practice Address - Country:US
Practice Address - Phone:832-725-7619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-24
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77309101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health