Provider Demographics
NPI:1912743154
Name:CARPENTER, SAMANTHA D (MS, LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:D
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:MS, LPC-ASSOCIATE
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:D
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 22
Mailing Address - Street 2:
Mailing Address - City:MACDONA
Mailing Address - State:TX
Mailing Address - Zip Code:78054-0022
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2939 W WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-5015
Practice Address - Country:US
Practice Address - Phone:210-212-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93292101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional