Provider Demographics
NPI:1487084745
Name:KHALID, SAMAN (LMHC)
Entity type:Individual
Prefix:
First Name:SAMAN
Middle Name:
Last Name:KHALID
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 1:100 MEDWAY ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4402
Mailing Address - Country:US
Mailing Address - Phone:401-365-4276
Mailing Address - Fax:
Practice Address - Street 1:100 MEDWAY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-4402
Practice Address - Country:US
Practice Address - Phone:401-365-4276
Practice Address - Fax:401-454-5565
Is Sole Proprietor?:No
Enumeration Date:2013-11-22
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MHC00936101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health