Provider Demographics
NPI:1851081319
Name:SAMANTHA PODSTUPKA THERAPY
Entity Type:Organization
Organization Name:SAMANTHA PODSTUPKA THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:SEGALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-634-7331
Mailing Address - Street 1:4055 INCA ST APT 318
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-2680
Mailing Address - Country:US
Mailing Address - Phone:310-905-2905
Mailing Address - Fax:
Practice Address - Street 1:4055 INCA ST APT 318
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-2680
Practice Address - Country:US
Practice Address - Phone:310-905-2905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health