Provider Demographics
NPI:1194009506
Name:LOVING, SAMANTHA (MS,CRC,CBIS,VHA-CM)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:LOVING
Suffix:
Gender:F
Credentials:MS,CRC,CBIS,VHA-CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 BROAD ROCK BLVD
Mailing Address - Street 2:(652/116B)
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23249-0001
Mailing Address - Country:US
Mailing Address - Phone:804-252-7779
Mailing Address - Fax:804-675-5346
Practice Address - Street 1:1201 BROAD ROCK BLVD
Practice Address - Street 2:(652/116B)
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23249-0001
Practice Address - Country:US
Practice Address - Phone:804-252-7779
Practice Address - Fax:804-675-5346
Is Sole Proprietor?:No
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor