Provider Demographics
NPI:1346544897
Name:DAVIDS, SAMANTHA FRIEDMAN (LMSW, PHD)
Entity Type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:FRIEDMAN
Last Name:DAVIDS
Suffix:
Gender:F
Credentials:LMSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1785 W STADIUM BLVD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-5285
Mailing Address - Country:US
Mailing Address - Phone:734-707-1345
Mailing Address - Fax:
Practice Address - Street 1:1785 W STADIUM BLVD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-5285
Practice Address - Country:US
Practice Address - Phone:734-707-1345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010927631041C0700X
MI6301014865103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical