Provider Demographics
NPI:1881267391
Name:SAMUELS, SEIMA (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:SEIMA
Middle Name:
Last Name:SAMUELS
Suffix:
Gender:
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:SEIMA
Other - Middle Name:
Other - Last Name:GODOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:9530 COTTON GUM RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-3699
Mailing Address - Country:US
Mailing Address - Phone:347-651-5442
Mailing Address - Fax:
Practice Address - Street 1:4919 MONROE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-7821
Practice Address - Country:US
Practice Address - Phone:704-440-5657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
NCC0182641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty