Provider Demographics
NPI:1518191931
Name:NGETICH, SAMMY K (MA, LPC, NCC,)
Entity Type:Individual
Prefix:
First Name:SAMMY
Middle Name:K
Last Name:NGETICH
Suffix:
Gender:M
Credentials:MA, LPC, NCC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27411-0002
Mailing Address - Country:US
Mailing Address - Phone:336-334-7727
Mailing Address - Fax:
Practice Address - Street 1:1601 E MARKET ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27411-0002
Practice Address - Country:US
Practice Address - Phone:336-334-7727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6683101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor