Provider Demographics
NPI:1235515834
Name:NIEMEYER, SAMANTHA (LPCC-S)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:NIEMEYER
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 COLUMBUS AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-1749
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:767 COLUMBUS AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-1749
Practice Address - Country:US
Practice Address - Phone:513-231-6630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE. 0900336101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health