Provider Demographics
NPI:1295619708
Name:ABBASI, SAMAR (LLPC)
Entity type:Individual
Prefix:MRS
First Name:SAMAR
Middle Name:
Last Name:ABBASI
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6953 CRESTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-1917
Mailing Address - Country:US
Mailing Address - Phone:133-694-9433
Mailing Address - Fax:
Practice Address - Street 1:1900 W STADIUM BLVD STE 1
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-7008
Practice Address - Country:US
Practice Address - Phone:734-904-1078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI316280101YS0200X
MI6451023161101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool