Provider Demographics
NPI:1285048686
Name:SUNDERMEYER, SAMANTHA N (MA, ATR, LMHC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:N
Last Name:SUNDERMEYER
Suffix:
Gender:F
Credentials:MA, ATR, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:387 OLD BAY RD
Mailing Address - Street 2:
Mailing Address - City:BOLTON
Mailing Address - State:MA
Mailing Address - Zip Code:01740-1253
Mailing Address - Country:US
Mailing Address - Phone:203-217-5678
Mailing Address - Fax:
Practice Address - Street 1:401 MAIN ST
Practice Address - Street 2:
Practice Address - City:BOLTON
Practice Address - State:MA
Practice Address - Zip Code:01740-1147
Practice Address - Country:US
Practice Address - Phone:978-618-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-13
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health