Staggs, Samuel

Staggs, Samuel is an individual health care provider with primary practice located at 513 Madison Ave , Covington KY 41011-1562. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Staggs, Samuel can be contacted via phone (859) 331-3292.

Contact Information

Primary practice address
513 Madison Ave Covington KY 41011-1562
Fax: (859) 578-2864
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 164155 Kentucky

Profile Details

NPI number 1982974630
LBN Legal business name Staggs, Samuel
Credentials Master of Education (MED)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2012
Last updated Aug 10th, 2016 - about 9 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 1982974630 NPPES
Kentucky Other 610661458 TAX ID

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