Provider Demographics
NPI:1215790191
Name:BARONE, SAMANTHA MARIA (LMHC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:MARIA
Last Name:BARONE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-4838
Mailing Address - Country:US
Mailing Address - Phone:631-835-1167
Mailing Address - Fax:
Practice Address - Street 1:211 MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-4838
Practice Address - Country:US
Practice Address - Phone:631-835-1167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-02
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014064101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health