Provider Demographics
NPI:1801373899
Name:LUX, SAMANTHA MARGARET (MSCCC-SLP)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:MARGARET
Last Name:LUX
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:MARGARET
Other - Last Name:LEMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:147 EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-2946
Mailing Address - Country:US
Mailing Address - Phone:770-843-3624
Mailing Address - Fax:
Practice Address - Street 1:211 PRIME PT STE D
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3334
Practice Address - Country:US
Practice Address - Phone:470-410-7323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP012934235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist