Provider Demographics
NPI:1013479690
Name:SKURJA, SAMANTHA ANNI (LAMFT)
Entity Type:Individual
Prefix:MISS
First Name:SAMANTHA
Middle Name:ANNI
Last Name:SKURJA
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6857 HIGHWAY 16 STE 1013
Mailing Address - Street 2:
Mailing Address - City:SENOIA
Mailing Address - State:GA
Mailing Address - Zip Code:30276-8602
Mailing Address - Country:US
Mailing Address - Phone:404-907-3958
Mailing Address - Fax:
Practice Address - Street 1:120 VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:SENOIA
Practice Address - State:GA
Practice Address - Zip Code:30276-3374
Practice Address - Country:US
Practice Address - Phone:470-447-2129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2023-12-04
Deactivation Date:2022-04-19
Deactivation Code:
Reactivation Date:2022-06-24
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist