Provider Demographics
NPI:1225147440
Name:SAMS, JANICE W (LC SWC)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:W
Last Name:SAMS
Suffix:
Gender:F
Credentials:LC SWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9650 SANTIAGO RD
Mailing Address - Street 2:STE. 101
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3957
Mailing Address - Country:US
Mailing Address - Phone:410-995-5587
Mailing Address - Fax:410-992-1779
Practice Address - Street 1:9650 SANTIAGO RD
Practice Address - Street 2:STE. 101
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3957
Practice Address - Country:US
Practice Address - Phone:410-995-5587
Practice Address - Fax:410-992-1779
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD009381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD341L615RMedicare PIN