Samantha Favara, LMHC

Individual provider Active NPI Mental Health Counselor · Middletown, NY

NPI 1053867937 · NPPES record last updated Aug 30, 2016

Key facts

NPI
1053867937
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
007423 (NY)
Practice address
41 Dolson Ave
Middletown, NY 10940-6489
Phone
(845) 342-5789
Fax
(845) 344-0510
NPI assigned
Aug 30, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 007423 NY Yes

Addresses

Primary practice location

41 Dolson Ave
Middletown, NY 10940-6489

Mailing address

41 Dolson Ave
Middletown, NY 10940-6489
Phone (845) 342-5789

Other providers in Middletown, NY

All providers in Middletown, NY · Mental Health Counselor in New York

Sources for this page

Verify at the official NPI Registry.