Provider Demographics
NPI:1285826743
Name:SAMSON, PATRICIA A (MS, LMHC, NCC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:SAMSON
Suffix:
Gender:F
Credentials:MS, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 ENGLISH AVE
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13408-1921
Mailing Address - Country:US
Mailing Address - Phone:315-415-7969
Mailing Address - Fax:
Practice Address - Street 1:45 LEBANON ST FL 1
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NY
Practice Address - Zip Code:13346-1225
Practice Address - Country:US
Practice Address - Phone:315-367-8458
Practice Address - Fax:315-883-1315
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-17
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY004273101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health