Provider Demographics
NPI:1851797724
Name:SAMSEL, COURTNEY
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:SAMSEL
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 1:1004 N BIG SPRING ST
Mailing Address - Street 2:SUITE 325
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-3354
Mailing Address - Country:US
Mailing Address - Phone:432-570-1084
Mailing Address - Fax:432-570-4069
Practice Address - Street 1:1004 N BIG SPRING ST
Practice Address - Street 2:SUITE 325
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-3354
Practice Address - Country:US
Practice Address - Phone:432-570-1084
Practice Address - Fax:432-570-4069
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-05
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69835101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional