Provider Demographics
NPI:1861185605
Name:CHASSEREAU, SAMANTHA SILVER (LPC-A)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:SILVER
Last Name:CHASSEREAU
Suffix:
Gender:
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 SADDLETREE PL
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-5556
Mailing Address - Country:US
Mailing Address - Phone:864-421-2779
Mailing Address - Fax:
Practice Address - Street 1:109 SADDLETREE PL
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-5556
Practice Address - Country:US
Practice Address - Phone:864-421-2779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-29
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8475101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health