Provider Demographics
NPI:1164876538
Name:COLEMAN, SAMANTHA MORGAN (LCAS, LCMHC)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:MORGAN
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LCAS, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-0098
Mailing Address - Country:US
Mailing Address - Phone:252-477-0008
Mailing Address - Fax:
Practice Address - Street 1:109 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-2528
Practice Address - Country:US
Practice Address - Phone:252-477-0008
Practice Address - Fax:252-303-0321
Is Sole Proprietor?:No
Enumeration Date:2016-04-21
Last Update Date:2023-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20540101YA0400X
NCA12463101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)