Provider Demographics
NPI:1306633920
Name:ALSPACH LANDESMAN, SAMANTHA M (LAC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:M
Last Name:ALSPACH LANDESMAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1766 W 29TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7816
Mailing Address - Country:US
Mailing Address - Phone:928-750-9770
Mailing Address - Fax:
Practice Address - Street 1:2585 E WILCOX DR
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2821
Practice Address - Country:US
Practice Address - Phone:520-378-5187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-23422101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health