Teklemariam, Samson

Teklemariam, Samson is an sole proprietor health care provider with primary practice located at 210 Emerson Heights Dr , Woodstock GA 30188-2522. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Teklemariam, Samson can be contacted via phone (678) 551-0287.

Contact Information

Primary practice address
210 Emerson Heights Dr Woodstock GA 30188-2522
Phone: (678) 551-0287
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 5606 South Carolina
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1699907501
LBN Legal business name Teklemariam, Samson
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 12th, 2009
Last updated May 20th, 2024 - about 6 months 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 1699907501 NPPES
South Carolina Other 3000641104 WORKER'S COMP
South Carolina MEDICAID 322842 WORKER'S COMP

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