Provider Demographics
NPI:1871262170
Name:HINNENKAMP, SAMANTHA FAITH (MA, PHD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:FAITH
Last Name:HINNENKAMP
Suffix:
Gender:F
Credentials:MA, PHD
Other - Prefix:
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Mailing Address - Street 1:1702 MILLER TRUNK HWY STE 209
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-4448
Mailing Address - Country:US
Mailing Address - Phone:218-524-8889
Mailing Address - Fax:
Practice Address - Street 1:1915 LYNDALE AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-3380
Practice Address - Country:US
Practice Address - Phone:800-336-5973
Practice Address - Fax:612-234-4689
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNLP6898103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical