Provider Demographics
NPI:1932409810
Name:SAMENFELD-SPECHT, ELIZABETH KAREN (LMFT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KAREN
Last Name:SAMENFELD-SPECHT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 LESTER LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:12850-2410
Mailing Address - Country:US
Mailing Address - Phone:207-712-0956
Mailing Address - Fax:
Practice Address - Street 1:453 DIXON RD
Practice Address - Street 2:BLDG 3, SUITE 6
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-1964
Practice Address - Country:US
Practice Address - Phone:207-712-0956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0007651106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist