Provider Demographics
NPI:1922301738
Name:MCGARRY, SAMANTHA (MS MHC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:MCGARRY
Suffix:
Gender:F
Credentials:MS MHC
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:L
Other - Last Name:PUCHACZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS MHC
Mailing Address - Street 1:607 DIVISION STREET
Mailing Address - Street 2:
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:607 DIVISION STREET
Practice Address - Street 2:
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99762
Practice Address - Country:US
Practice Address - Phone:907-443-3344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-16
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator