Provider Demographics
NPI:1851952691
Name:RAUBER, SAMANTHA MAINIERI (LPC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:MAINIERI
Last Name:RAUBER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 PECAN DR
Mailing Address - Street 2:
Mailing Address - City:SAINT GABRIEL
Mailing Address - State:LA
Mailing Address - Zip Code:70776-5512
Mailing Address - Country:US
Mailing Address - Phone:225-953-0474
Mailing Address - Fax:
Practice Address - Street 1:1663 KEED AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-8138
Practice Address - Country:US
Practice Address - Phone:225-230-4650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health