Provider Demographics
NPI:1629457486
Name:FLINT, SAMANTHA RUTH (LCSW, CSW, ASW)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:RUTH
Last Name:FLINT
Suffix:
Gender:F
Credentials:LCSW, CSW, ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 RING RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-9454
Mailing Address - Country:US
Mailing Address - Phone:760-853-4755
Mailing Address - Fax:
Practice Address - Street 1:2000 RING RD
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-9454
Practice Address - Country:US
Practice Address - Phone:270-506-2730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2562491041C0700X
104100000X
CA94751101YM0800X, 1041C0700X
OH1041C0700X
KY72511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health