Provider Demographics
NPI:1124452529
Name:MAIORI, SAMANTHA (LCSW)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:MAIORI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C/O BRIDGEPORT HOSPITAL REACH PROGRAM
Mailing Address - Street 2:1558 BARNUM AVE.
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06610-3238
Mailing Address - Country:US
Mailing Address - Phone:203-384-3653
Mailing Address - Fax:203-378-8578
Practice Address - Street 1:91-2301 OLD FT WEAVER RD
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-3602
Practice Address - Country:US
Practice Address - Phone:808-671-8511
Practice Address - Fax:808-677-2570
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILSW-20541041C0700X
CT0101411041C0700X
HILCSW-41341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical