Provider Demographics
NPI:1073263216
Name:NORRIS, SAMANTHA (LGPC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:NORRIS
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3054 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21102-1980
Mailing Address - Country:US
Mailing Address - Phone:443-761-5732
Mailing Address - Fax:
Practice Address - Street 1:516 N ROLLING RD STE 201B
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4490
Practice Address - Country:US
Practice Address - Phone:443-405-2878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-28
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP12461101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health