Provider Demographics
NPI:1992859888
Name:SAMMS-LEZAMA, MARGUERITE VIVIENNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARGUERITE
Middle Name:VIVIENNE
Last Name:SAMMS-LEZAMA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13929 223RD ST
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-2730
Mailing Address - Country:US
Mailing Address - Phone:718-527-8488
Mailing Address - Fax:
Practice Address - Street 1:2581 ATLANTIC AVENUE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207
Practice Address - Country:US
Practice Address - Phone:718-495-6700
Practice Address - Fax:718-485-4018
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0735221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical