Provider Demographics
NPI:1003276353
Name:KAY, SAMANTHA ASHLEY (MS, LMHC)
Entity Type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:ASHLEY
Last Name:KAY
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1954 HOWELL BRANCH RD STE 106
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-1041
Mailing Address - Country:US
Mailing Address - Phone:407-490-0489
Mailing Address - Fax:
Practice Address - Street 1:1954 HOWELL BRANCH RD STE 106
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-1041
Practice Address - Country:US
Practice Address - Phone:407-490-0489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-29
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLMH 14151101YM0800X
FLMH15502101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health