Provider Demographics
NPI:1508744624
Name:SAMANTHA CONGDON LLC
Entity type:Organization
Organization Name:SAMANTHA CONGDON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONGDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-600-0831
Mailing Address - Street 1:6806 WELLS PKWY
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20782-1054
Mailing Address - Country:US
Mailing Address - Phone:240-600-0831
Mailing Address - Fax:
Practice Address - Street 1:6806 WELLS PKWY
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:MD
Practice Address - Zip Code:20782-1054
Practice Address - Country:US
Practice Address - Phone:240-600-0831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty