Provider Demographics
NPI:1699465088
Name:SAMPSON, ROLLANDE PAQUIN (LCMHC, NCC)
Entity type:Individual
Prefix:
First Name:ROLLANDE
Middle Name:PAQUIN
Last Name:SAMPSON
Suffix:
Gender:
Credentials:LCMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 85
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-0085
Mailing Address - Country:US
Mailing Address - Phone:910-724-0043
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 85
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-0085
Practice Address - Country:US
Practice Address - Phone:910-724-0043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-10
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15738101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health