Provider Demographics
NPI:1336997121
Name:CAURDY, SAM DOUGLAS
Entity Type:Individual
Prefix:
First Name:SAM
Middle Name:DOUGLAS
Last Name:CAURDY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 SCOTT LN
Mailing Address - Street 2:
Mailing Address - City:VENETIA
Mailing Address - State:PA
Mailing Address - Zip Code:15367-1115
Mailing Address - Country:US
Mailing Address - Phone:810-844-6697
Mailing Address - Fax:
Practice Address - Street 1:2000 WATERDAM PLAZA DR STE 240
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-5411
Practice Address - Country:US
Practice Address - Phone:412-219-7378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor