Fortin, Samantha

Fortin, Samantha is an individual health care provider with primary practice located at 13213 E 14 Mile Rd , Sterling Heights MI 48312-6302. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Technologists, Technicians & Other Technical Service Providers / Technician, Other, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Fortin, Samantha can be contacted via phone (586) 939-4374.

Contact Information

Primary practice address
13213 E 14 Mile Rd Sterling Heights MI 48312-6302
Phone: (586) 939-4374
Fax: (586) 939-4783
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X
Technologists, Technicians & Other Technical Service Providers / Technician, Other 247200000X
Behavioral Health & Social Service Providers / Social Worker 104100000X 6801102790 Michigan

Profile Details

NPI number 1174914808
LBN Legal business name Fortin, Samantha
Credentials LMSW
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2015
Last updated Jun 16th, 2022 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1174914808 NPPES
Michigan Other 6801102790 LLMSW LICENSE NUMBER
Michigan Other 6801108455 LLMSW LICENSE NUMBER

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