Provider Demographics
NPI:1891507083
Name:WATERS, SAMANTHA (MSW)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:WATERS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:BARTON WATERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:2481 N DECATUR BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-2957
Mailing Address - Country:US
Mailing Address - Phone:702-527-6337
Mailing Address - Fax:702-979-9688
Practice Address - Street 1:2481 N DECATUR BLVD STE D
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-2957
Practice Address - Country:US
Practice Address - Phone:702-527-6337
Practice Address - Fax:702-979-9688
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker