Provider Demographics
NPI:1750026076
Name:TODOROVICH, SAMANTHA (MED, LGPC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:TODOROVICH
Suffix:
Gender:F
Credentials:MED, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 CATHEDRAL ST STE 1R
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5297
Mailing Address - Country:US
Mailing Address - Phone:410-302-9500
Mailing Address - Fax:
Practice Address - Street 1:565 LIVONIA AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-5209
Practice Address - Country:US
Practice Address - Phone:646-465-5352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-02
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP15497101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health