Provider Demographics
NPI:1740842830
Name:BRASFIELD, SAMANTHA (LPC/LCMHC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:BRASFIELD
Suffix:
Gender:F
Credentials:LPC/LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 5TH AVE # 260
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-7002
Mailing Address - Country:US
Mailing Address - Phone:917-588-0252
Mailing Address - Fax:
Practice Address - Street 1:397 BRIDGE ST FL 7
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5247
Practice Address - Country:US
Practice Address - Phone:917-588-0252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-28
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14603101YM0800X
AL4344101YM0800X
WALH61227159101YM0800X
NC14603101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty