Provider Demographics
NPI:1932881539
Name:TINSLEY, SAMARA J
Entity type:Individual
Prefix:
First Name:SAMARA
Middle Name:J
Last Name:TINSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9535 N STAFFORD DR
Mailing Address - Street 2:
Mailing Address - City:CITRUS SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34433-4014
Mailing Address - Country:US
Mailing Address - Phone:561-315-3791
Mailing Address - Fax:
Practice Address - Street 1:110 S APOPKA AVE
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4837
Practice Address - Country:US
Practice Address - Phone:352-560-7027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health