Provider Demographics
NPI:1265030712
Name:BARLEY, SAMANTHA
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:BARLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5239 S HONEYSUCKLE LN
Mailing Address - Street 2:
Mailing Address - City:BATTLEFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65619-8292
Mailing Address - Country:US
Mailing Address - Phone:717-779-9318
Mailing Address - Fax:
Practice Address - Street 1:16055 PERRY HWY BLDG 3
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-6885
Practice Address - Country:US
Practice Address - Phone:724-443-8900
Practice Address - Fax:724-443-8939
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2021-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0213951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical