Provider Demographics
NPI:1811406226
Name:BORGIDA, SAMANTHA BLAKE (LCSW)
Entity type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:BLAKE
Last Name:BORGIDA
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:SAMANTHA
Other - Middle Name:BLAKE
Other - Last Name:ARFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:250 E 30TH ST APT 4C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8296
Mailing Address - Country:US
Mailing Address - Phone:516-458-1718
Mailing Address - Fax:
Practice Address - Street 1:2445 HOLLY AVE APT 139
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3992
Practice Address - Country:US
Practice Address - Phone:301-456-0179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101085-11041C0700X
MD284701041C0700X
NY0910911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical