Provider Demographics
NPI:1255615795
Name:SOHMER, SAMANTHA RACHEL (LCSW)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:RACHEL
Last Name:SOHMER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 GREAT OAKS RD
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1607
Mailing Address - Country:US
Mailing Address - Phone:516-484-0650
Mailing Address - Fax:
Practice Address - Street 1:86 GREAT OAKS RD
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-1607
Practice Address - Country:US
Practice Address - Phone:516-484-0650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-03
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0724631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical