Provider Demographics
NPI:1972398808
Name:SAMPSON, CALEB
Entity type:Individual
Prefix:
First Name:CALEB
Middle Name:
Last Name:SAMPSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 BLANCHARD ST APT 5303
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-7895
Mailing Address - Country:US
Mailing Address - Phone:504-688-9646
Mailing Address - Fax:
Practice Address - Street 1:2101 TOWER DR STE B
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5045
Practice Address - Country:US
Practice Address - Phone:318-570-5400
Practice Address - Fax:318-570-5403
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-11
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator