Provider Demographics
NPI:1982936738
Name:DOVERSBERGER, SAMANTHA MARIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:MARIE
Last Name:DOVERSBERGER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 CAMERON RD
Mailing Address - Street 2:BLDG 2 SUITE 251
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-3831
Mailing Address - Country:US
Mailing Address - Phone:512-537-8621
Mailing Address - Fax:
Practice Address - Street 1:7901 CAMERON RD
Practice Address - Street 2:BLDG 2 SUITE 251
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-3831
Practice Address - Country:US
Practice Address - Phone:512-537-8621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX515781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical