Lawless, Sam

Lawless, Sam is an individual health care provider with primary practice located at 1955 Us Highway 1 S Suite C-2, St Augustine FL 32086-3708. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Lawless, Sam can be contacted via phone (904) 209-6001.

Contact Information

Primary practice address
1955 Us Highway 1 S Suite C-2 St Augustine FL 32086-3708
Phone: (904) 209-6001
Fax: (904) 209-6002
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW9129 Florida

Profile Details

NPI number 1467441980
LBN Legal business name Lawless, Sam
Credentials MSW
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2005
Last updated Jan 21st, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1467441980 NPPES
Florida MEDICAID 757217400

Popular Providers