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DR. SANDRA LEA SAMONS PH.D., M.S.W.

Addiction Substance Use Disorder

Ann Arbor, Michigan

Provider NPI: 1376536367

Provider Information:
DR. SANDRA LEA SAMONS PH.D., M.S.W.
Gender: F


Practice Location:
1480 SHEVCHENKO DR  ANN ARBOR, MI 48103 US
Tel: 173-466-3787  Fax: --

Business Mailing Address:
1480 SHEVCHENKO DR  ANN ARBOR, MI 48103 US
Tel: 173-466-3787  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
MI2-00035
X104100000XBehavioral Health & Social Service Providers
Social Worker
MIGENDER IDENTITY SPEC
X1041C0700XBehavioral Health & Social Service Providers
Social Worker
MI6810103579
X106H00000XBehavioral Health & Social Service Providers
Marriage & Family Therapist
MI4101005512

Other Provider Identifiers:

IssuerNumberStateType
REGISTERED CERTIFIED S. W6801013579MI01
LMFT4101005512MI01
MI CERT. BOARD FOR ADDIC2-00035MI01
MI ASSC OF A/DA COUNSELOR8499MI01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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