Provider Demographics
NPI:1164960944
Name:SAMUELS, NATALIE JO (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:JO
Last Name:SAMUELS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MISS
Other - First Name:NATALIE
Other - Middle Name:JO
Other - Last Name:SEITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 N ALABAMA ST STE 350
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-2275
Mailing Address - Country:US
Mailing Address - Phone:317-932-1900
Mailing Address - Fax:
Practice Address - Street 1:333 N ALABAMA ST STE 350
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-2275
Practice Address - Country:US
Practice Address - Phone:317-932-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34008438A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical