Provider Demographics
NPI:1467705574
Name:SPERLING, SAMANTHA MARIE (BS CADC)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:MARIE
Last Name:SPERLING
Suffix:
Gender:F
Credentials:BS CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 MAPLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MADRID
Mailing Address - State:IA
Mailing Address - Zip Code:50156-1100
Mailing Address - Country:US
Mailing Address - Phone:712-249-8456
Mailing Address - Fax:
Practice Address - Street 1:110 MAPLE RIDGE DR
Practice Address - Street 2:
Practice Address - City:MADRID
Practice Address - State:IA
Practice Address - Zip Code:50156-1100
Practice Address - Country:US
Practice Address - Phone:712-249-8456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)