Provider Demographics
NPI:1619640687
Name:SAMLOW, BRANDEE (LCMHCA)
Entity Type:Individual
Prefix:MRS
First Name:BRANDEE
Middle Name:
Last Name:SAMLOW
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 1:4215 RIVER BIRCH LOOP APT 1E
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-8041
Mailing Address - Country:US
Mailing Address - Phone:630-656-3558
Mailing Address - Fax:
Practice Address - Street 1:4215 RIVER BIRCH LOOP APT 1E
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-8041
Practice Address - Country:US
Practice Address - Phone:630-656-3558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16616101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health