Provider Demographics
NPI:1235920604
Name:SAMUELS, CHRISTA (MS, NCC, LPC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTA
Middle Name:
Last Name:SAMUELS
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 POND BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:NORTH
Mailing Address - State:SC
Mailing Address - Zip Code:29112-8903
Mailing Address - Country:US
Mailing Address - Phone:803-308-5081
Mailing Address - Fax:
Practice Address - Street 1:1545 LEGRAND RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-6310
Practice Address - Country:US
Practice Address - Phone:803-619-0423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-15
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10968101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional