Provider Demographics
NPI:1134094725
Name:SHOWN, SAMANTHA (MA)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:SHOWN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 103
Mailing Address - Street 2:
Mailing Address - City:ARAPAHOE
Mailing Address - State:NC
Mailing Address - Zip Code:28510-0103
Mailing Address - Country:US
Mailing Address - Phone:984-246-2856
Mailing Address - Fax:984-246-2897
Practice Address - Street 1:PO BOX 103
Practice Address - Street 2:
Practice Address - City:ARAPAHOE
Practice Address - State:NC
Practice Address - Zip Code:28510-0103
Practice Address - Country:US
Practice Address - Phone:984-246-2856
Practice Address - Fax:984-246-2897
Is Sole Proprietor?:No
Enumeration Date:2025-10-06
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21953101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health