Provider Demographics
NPI:1992570865
Name:SCHUSSLER, SAMANTHA (LAC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:SCHUSSLER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 FOOTHILL RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2255
Mailing Address - Country:US
Mailing Address - Phone:908-944-7944
Mailing Address - Fax:732-475-6172
Practice Address - Street 1:940 CEDAR BRIDGE AVE FL 2
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-4170
Practice Address - Country:US
Practice Address - Phone:908-944-7944
Practice Address - Fax:732-475-6175
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00628600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health