Provider Demographics
NPI:1912881400
Name:LAMOUR, SAMANTHA VICTORIA
Entity type:Individual
Prefix:MISS
First Name:SAMANTHA
Middle Name:VICTORIA
Last Name:LAMOUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 MESHAKA ST
Mailing Address - Street 2:
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-6308
Mailing Address - Country:US
Mailing Address - Phone:617-637-0084
Mailing Address - Fax:
Practice Address - Street 1:400 N MAIN ST # 402
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4177
Practice Address - Country:US
Practice Address - Phone:781-986-4800
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
MA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty