Agins, Samantha Kelsey

Agins, Samantha Kelsey is an sole proprietor health care provider with primary practice located at 152 Elgin Ave , Forest Park IL 60130. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Agins, Samantha Kelsey can be contacted via phone (224) 639-7776.

Contact Information

Primary practice address
152 Elgin Ave Forest Park IL 60130
Phone: (224) 639-7776
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 178.013428 Illinois

Profile Details

NPI number 1275030199
LBN Legal business name Agins, Samantha Kelsey
Credentials M.A., LCPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 8th, 2018
Last updated Feb 25th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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