Provider Information for 1619521325
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SAMANTHA COLEY MA, LCHMC, LPC
Other Names:Former Name:SAMANTHA BECKELHIMER MA, LCMHC, LPCSex: Female
NPI: 1619521325
Last Updated: 2023-06-21
Certification Date: 2023-06-21
Certification Date: 2023-06-21
Details
| Name | Value | ||||||||||||||||
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| NPI | 1619521325 | ||||||||||||||||
| Enumeration Date | 2019-07-31 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 2355 STATE ST STE 101 SALEM, OR 97301-4541 United States Phone: 503-967-5654 | Fax: | ||||||||||||||||
| Primary Practice Address | 2355 STATE ST STE 101 SALEM, OR 97301-4541 United States Phone: 503-967-5654 | Fax: | ||||||||||||||||
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