Provider Demographics
NPI:1437910551
Name:GIARDINA, SAMANTHA HALEY (LCMHCA)
Entity Type:Individual
Prefix:MISS
First Name:SAMANTHA
Middle Name:HALEY
Last Name:GIARDINA
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18809 W CATAWBA AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-5548
Mailing Address - Country:US
Mailing Address - Phone:704-840-5035
Mailing Address - Fax:
Practice Address - Street 1:18809 W CATAWBA AVE STE 202
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5548
Practice Address - Country:US
Practice Address - Phone:704-840-5035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19461101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor