Provider Demographics
NPI:1225419419
Name:ALLEN, SAMUEL H (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:H
Last Name:ALLEN
Suffix:
Gender:M
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 N FRANCISCO AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3609
Mailing Address - Country:US
Mailing Address - Phone:443-452-8674
Mailing Address - Fax:
Practice Address - Street 1:5001 N FRANCISCO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3609
Practice Address - Country:US
Practice Address - Phone:443-452-8674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-12
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1164311767OtherCMS