Provider Demographics
NPI:1740153766
Name:SAMANTHA HYNES LLC
Entity type:Organization
Organization Name:SAMANTHA HYNES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HYNES
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:407-451-2557
Mailing Address - Street 1:3316 SE 51ST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-3005
Mailing Address - Country:US
Mailing Address - Phone:407-451-2557
Mailing Address - Fax:
Practice Address - Street 1:3316 SE 51ST AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-3005
Practice Address - Country:US
Practice Address - Phone:407-451-2557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty