Provider Demographics
NPI:1144428905
Name:PAULEY, SAMANTHA FELTS (LPC, LMFT, MAC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:FELTS
Last Name:PAULEY
Suffix:
Gender:F
Credentials:LPC, LMFT, MAC
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:JEAN
Other - Last Name:FELTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8625 SW LIZZIE CT
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-7097
Mailing Address - Country:US
Mailing Address - Phone:503-505-4191
Mailing Address - Fax:
Practice Address - Street 1:6600 SW 105TH AVE STE 115
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-8833
Practice Address - Country:US
Practice Address - Phone:503-644-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)