Provider Demographics
NPI:1457726127
Name:KROENER, SAMANTHA CAROLINE (LMHC)
Entity Type:Individual
Prefix:MISS
First Name:SAMANTHA
Middle Name:CAROLINE
Last Name:KROENER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:CAROLINE
Other - Last Name:RUNDLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:205 SOUTH AVENUE SUITE 105
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601
Mailing Address - Country:US
Mailing Address - Phone:845-554-1365
Mailing Address - Fax:845-554-1376
Practice Address - Street 1:205 SOUTH AVENUE SUITE 105
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601
Practice Address - Country:US
Practice Address - Phone:845-554-1365
Practice Address - Fax:845-554-1376
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-07
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)