Provider Demographics
NPI:1124423041
Name:SAMANTHA BURNS ARTHERHOLT, PHD, LLC
Entity type:Organization
Organization Name:SAMANTHA BURNS ARTHERHOLT, PHD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:BURNS
Authorized Official - Last Name:ARTHERHOLT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:206-412-0142
Mailing Address - Street 1:PO BOX 27136
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98165-1536
Mailing Address - Country:US
Mailing Address - Phone:414-533-5825
Mailing Address - Fax:
Practice Address - Street 1:600 STEWART ST STE 724
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1227
Practice Address - Country:US
Practice Address - Phone:414-533-5825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC0700X
WAPY00003648261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty