Provider Demographics
NPI:1487101523
Name:TRAPP, SAMANTHA (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:TRAPP
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 SKOKIE BLVD STE 218
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-4043
Mailing Address - Country:US
Mailing Address - Phone:847-668-4295
Mailing Address - Fax:847-668-4295
Practice Address - Street 1:900 SKOKIE BLVD STE 218
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4043
Practice Address - Country:US
Practice Address - Phone:847-668-4295
Practice Address - Fax:847-668-4295
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490215121041C0700X
MI6802089085104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical