Provider Demographics
NPI:1568197929
Name:SADA, SAMANTHA ROXANNE (LCSW)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:ROXANNE
Last Name:SADA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5109 MEDICAL DR FL 4
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5068
Mailing Address - Country:US
Mailing Address - Phone:210-450-7090
Mailing Address - Fax:210-450-2460
Practice Address - Street 1:5109 MEDICAL DR FL 4
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5068
Practice Address - Country:US
Practice Address - Phone:210-450-7090
Practice Address - Fax:210-450-2460
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63355104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker