Provider Demographics
NPI:1669194387
Name:DARROW, SAMANTHA (MA)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:DARROW
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 1:3757 FLAMINGO AVE SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49509-3864
Mailing Address - Country:US
Mailing Address - Phone:517-944-4901
Mailing Address - Fax:
Practice Address - Street 1:3757 FLAMINGO AVE SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49509-3864
Practice Address - Country:US
Practice Address - Phone:517-944-4901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451022531101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor