Provider Demographics
NPI:1225888258
Name:FELTON, SAMANTHA WOOLDRIDGE (LPC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:WOOLDRIDGE
Last Name:FELTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15309 ARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:DISPUTANTA
Mailing Address - State:VA
Mailing Address - Zip Code:23842-7430
Mailing Address - Country:US
Mailing Address - Phone:804-731-1888
Mailing Address - Fax:
Practice Address - Street 1:804 MOOREFIELD PARK DR STE 204
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3670
Practice Address - Country:US
Practice Address - Phone:804-638-3626
Practice Address - Fax:804-256-0236
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0701013411101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional