Provider Demographics
NPI:1114639978
Name:SAIA, SAMUEL (LCASA, MA)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:SAIA
Suffix:
Gender:M
Credentials:LCASA, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5017 SHADYSIDE CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-5122
Mailing Address - Country:US
Mailing Address - Phone:704-728-2403
Mailing Address - Fax:
Practice Address - Street 1:11020 S TRYON ST STE 408
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-6662
Practice Address - Country:US
Practice Address - Phone:980-236-1660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-22
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)