Provider Demographics
NPI:1134946809
Name:SAKRY, SAMENTHA KAY (MSW, LGSW)
Entity type:Individual
Prefix:
First Name:SAMENTHA
Middle Name:KAY
Last Name:SAKRY
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5573 N TISHER RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55804
Mailing Address - Country:US
Mailing Address - Phone:612-237-8015
Mailing Address - Fax:
Practice Address - Street 1:1618 CLOQUET AVE
Practice Address - Street 2:
Practice Address - City:CLOQUET
Practice Address - State:MN
Practice Address - Zip Code:55720-1948
Practice Address - Country:US
Practice Address - Phone:218-451-2116
Practice Address - Fax:218-219-1511
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN315031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical