Provider Demographics
NPI:1437867736
Name:SAMPLES, ALLISON JO (MA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:JO
Last Name:SAMPLES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 QUARRIER ST STE 310
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-2338
Mailing Address - Country:US
Mailing Address - Phone:304-513-3900
Mailing Address - Fax:
Practice Address - Street 1:601 WILLIAMS DR
Practice Address - Street 2:
Practice Address - City:NITRO
Practice Address - State:WV
Practice Address - Zip Code:25143-1536
Practice Address - Country:US
Practice Address - Phone:304-553-2663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health