Provider Demographics
NPI:1255641189
Name:GERAGHTY, SAMIA (LPC)
Entity type:Individual
Prefix:MS
First Name:SAMIA
Middle Name:
Last Name:GERAGHTY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5906 VICKERY BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-6338
Mailing Address - Country:US
Mailing Address - Phone:214-734-0202
Mailing Address - Fax:
Practice Address - Street 1:5906 VICKERY BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-6338
Practice Address - Country:US
Practice Address - Phone:214-734-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17895101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional