Provider Demographics
NPI:1871862144
Name:POSTON, SAMANTHA (LPC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:POSTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1294 FOLLY GROVE RD
Mailing Address - Street 2:
Mailing Address - City:HEMINGWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29554
Mailing Address - Country:US
Mailing Address - Phone:216-534-4154
Mailing Address - Fax:
Practice Address - Street 1:1335 44TH AVE N STE 103
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-5978
Practice Address - Country:US
Practice Address - Phone:216-534-4154
Practice Address - Fax:843-620-1057
Is Sole Proprietor?:No
Enumeration Date:2011-12-15
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5334101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC1810Medicaid