Brockmeyer, Samantha J
Brockmeyer, Samantha J is an sole proprietor health care provider with primary practice located at 525 Avon Belden Rd Ste 1 , Avon Lake OH 44012-4101. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Brockmeyer, Samantha J can be contacted via phone (216) 302-7805.Contact Information
Primary practice address
525 Avon Belden Rd Ste 1
Avon Lake OH 44012-4101
Phone: (216) 302-7805
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | CDCA.169590 | Ohio |
Other Service Providers / Case Manager/Care Coordinator | 171M00000X | ||
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | S.2005043 | Ohio |
Profile Details
NPI number | 1962980888 |
---|---|
LBN Legal business name | Brockmeyer, Samantha J |
Credentials | Bachelor of Arts (BA) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Aug 2nd, 2018 |
Last updated | Jul 13th, 2020 - about 4 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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