Provider Demographics
NPI:1356828776
Name:STEIN, SAMANTHA D (PSYD)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:D
Last Name:STEIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 S STEELE ST STE 250
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-2802
Mailing Address - Country:US
Mailing Address - Phone:720-449-2499
Mailing Address - Fax:720-634-0719
Practice Address - Street 1:50 S STEELE ST STE 250
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2802
Practice Address - Country:US
Practice Address - Phone:720-449-2499
Practice Address - Fax:720-634-0719
Is Sole Proprietor?:No
Enumeration Date:2018-07-27
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004833103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical