Clarke, Samantha K
Clarke, Samantha K is an individual health care provider with primary practice located at 113 Elm St Ste 204 , Enfield CT 06082-3739. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Clarke, Samantha K can be contacted via phone (860) 741-3001.Contact Information
Primary practice address
113 Elm St Ste 204
Enfield CT 06082-3739
Phone: (860) 741-3001
Fax: (086) 741-8332
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 002170 | Connecticut |
Profile Details
| NPI number | 1306103445 |
|---|---|
| LBN Legal business name | Clarke, Samantha K |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 13th, 2012 |
| Last updated | Apr 13th, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306103445 | NPPES |
| Connecticut | Other | A412956 | OXFORD |
| Connecticut | Other | 4553929 | OXFORD |
| Connecticut | Other | 201366 | OXFORD |
| Connecticut | MEDICAID | 004121141 | OXFORD |
| Connecticut | Other | 321137/A324839 | OXFORD |
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