Provider Demographics
NPI:1770777898
Name:SAMB, CATHERINE (LPC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:SAMB
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 N CTY TRK HWY F
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53547-1649
Mailing Address - Country:US
Mailing Address - Phone:608-757-5281
Mailing Address - Fax:608-758-8418
Practice Address - Street 1:3530 N CTY TRK HWY F
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53547-1649
Practice Address - Country:US
Practice Address - Phone:608-757-5281
Practice Address - Fax:608-758-8418
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2908125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional