Provider Demographics
NPI:1497574925
Name:NASER, SAMANTHA LESLIE
Entity type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:LESLIE
Last Name:NASER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16601 CHICAGO PLZ APT 5
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68118-4084
Mailing Address - Country:US
Mailing Address - Phone:402-616-6937
Mailing Address - Fax:
Practice Address - Street 1:3802 REDICK AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68112-2966
Practice Address - Country:US
Practice Address - Phone:531-299-9678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE135171041S0200X
NE78851041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool