Provider Demographics
NPI:1720791684
Name:MEI, SAMANTHA LYNN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:LYNN
Last Name:MEI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SAMANTHA
Other - Middle Name:LYNN
Other - Last Name:HUMPHREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:34 MONIKA LN
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-3931
Mailing Address - Country:US
Mailing Address - Phone:914-224-1203
Mailing Address - Fax:
Practice Address - Street 1:34 MONIKA LN
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-3931
Practice Address - Country:US
Practice Address - Phone:914-224-1203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5131104100000X
CT140331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker