Provider Demographics
NPI:1306122197
Name:SAMPSON THERAPEUTIC SERVICES
Entity type:Organization
Organization Name:SAMPSON THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LATRICE
Authorized Official - Middle Name:F
Authorized Official - Last Name:SAMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC
Authorized Official - Phone:504-729-7012
Mailing Address - Street 1:6641 WESTBANK EXPY
Mailing Address - Street 2:SUITE E
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-2663
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6641 WESTBANK EXPY
Practice Address - Street 2:SUITE E
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-2663
Practice Address - Country:US
Practice Address - Phone:504-301-2431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4346101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty