Provider Demographics
NPI:1104620814
Name:SPIDELL, SAMANTHA ANN (LMHC, QS)
Entity type:Individual
Prefix:MISS
First Name:SAMANTHA
Middle Name:ANN
Last Name:SPIDELL
Suffix:
Gender:
Credentials:LMHC, QS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 AVENUE L APT 206A
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-4613
Mailing Address - Country:US
Mailing Address - Phone:561-350-3563
Mailing Address - Fax:
Practice Address - Street 1:701 AVENUE L APT 206A
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-4613
Practice Address - Country:US
Practice Address - Phone:561-350-3563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18014101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health