Provider Demographics
NPI:1457026502
Name:CALALUCA, SAMANTHA (MA, LPC-R)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:CALALUCA
Suffix:
Gender:F
Credentials:MA, LPC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22610 WILDERNESS ACRES CIR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-4843
Mailing Address - Country:US
Mailing Address - Phone:703-577-9199
Mailing Address - Fax:
Practice Address - Street 1:20145 ASHBROOK PL STE 180
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-3373
Practice Address - Country:US
Practice Address - Phone:703-957-0350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health