Provider Demographics
NPI:1447096888
Name:KAUFFMAN, SAMANTHA (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:KAUFFMAN
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 S FLEISHEL AVE APT 333
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75702-0009
Mailing Address - Country:US
Mailing Address - Phone:409-553-9293
Mailing Address - Fax:
Practice Address - Street 1:420 S FLEISHEL AVE APT 333
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-0009
Practice Address - Country:US
Practice Address - Phone:409-553-9293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-04
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91431101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health