Provider Demographics
NPI:1417210337
Name:OWUSU, SAMANTHA HANNER (P-LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:HANNER
Last Name:OWUSU
Suffix:
Gender:F
Credentials:P-LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 E CARDINAL ST
Mailing Address - Street 2:
Mailing Address - City:SILER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27344-3300
Mailing Address - Country:US
Mailing Address - Phone:919-663-3050
Mailing Address - Fax:
Practice Address - Street 1:1105 E CARDINAL ST
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-3300
Practice Address - Country:US
Practice Address - Phone:919-663-3050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0066141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical