Provider Demographics
NPI:1679056808
Name:SAMSE, LORI
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:SAMSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 BERKELEY ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-1224
Mailing Address - Country:US
Mailing Address - Phone:978-682-1614
Mailing Address - Fax:
Practice Address - Street 1:150 BERKELEY ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-1224
Practice Address - Country:US
Practice Address - Phone:978-682-1614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical