Provider Demographics
NPI:1962021675
Name:SELIGMAN, SAMANTHA (LCSW, CASAC)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:SELIGMAN
Suffix:
Gender:F
Credentials:LCSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2461 E 29TH ST APT 2C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1945
Mailing Address - Country:US
Mailing Address - Phone:917-588-2422
Mailing Address - Fax:
Practice Address - Street 1:7701 13TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-2413
Practice Address - Country:US
Practice Address - Phone:929-278-5012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-13
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104891104100000X
NY0929291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker