Provider Demographics
NPI:1093504953
Name:CALIAS, SAMANTHA (LMHC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:CALIAS
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9770 BAYMEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-7909
Mailing Address - Country:US
Mailing Address - Phone:781-724-4099
Mailing Address - Fax:
Practice Address - Street 1:11590 DUNNS CROSSING DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-9341
Practice Address - Country:US
Practice Address - Phone:781-724-4099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24558101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health