Provider Demographics
NPI:1790100816
Name:PILLOW, SAMANTHA (LPC, CAADC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:PILLOW
Suffix:
Gender:F
Credentials:LPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10029 NICHOLS RD
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:MI
Mailing Address - Zip Code:48457-9173
Mailing Address - Country:US
Mailing Address - Phone:810-285-8429
Mailing Address - Fax:810-204-4950
Practice Address - Street 1:2029 S ELMS RD
Practice Address - Street 2:
Practice Address - City:SWARTZ CREEK
Practice Address - State:MI
Practice Address - Zip Code:48473-9766
Practice Address - Country:US
Practice Address - Phone:810-285-8429
Practice Address - Fax:810-204-4950
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014779101YA0400X, 101YP2500X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional