Provider Demographics
NPI:1538944947
Name:HARRIS-HORTON, SAMANTHA ANNETTE (LPC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:ANNETTE
Last Name:HARRIS-HORTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:SAMANTHA
Other - Middle Name:A
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5436 GREENPLAIN RD APT 201
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-2361
Mailing Address - Country:US
Mailing Address - Phone:708-256-5555
Mailing Address - Fax:
Practice Address - Street 1:141 PARKER ST STE 306
Practice Address - Street 2:
Practice Address - City:MAYNARD
Practice Address - State:MA
Practice Address - Zip Code:01754-2180
Practice Address - Country:US
Practice Address - Phone:866-991-2103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional