Provider Demographics
NPI:1518570803
Name:SAUNDERS, SAMANTHA (LPC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:12752 WOOD HOLLOW DR APT 1822
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-6548
Mailing Address - Country:US
Mailing Address - Phone:571-316-7509
Mailing Address - Fax:
Practice Address - Street 1:4004 GENESEE PL STE 101
Practice Address - Street 2:
Practice Address - City:LAKE RIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-8304
Practice Address - Country:US
Practice Address - Phone:703-495-3164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701009789101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional