Malcolm, Samantha

Malcolm, Samantha is an sole proprietor health care provider with primary practice located at 1030 Fayetteville Rd Se , Atlanta GA 30316-2921. She recently has 2 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Malcolm, Samantha can be contacted via phone (404) 486-9034.

Contact Information

Primary practice address
1030 Fayetteville Rd Se Atlanta GA 30316-2921
Phone: (404) 486-9034
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1508532177
LBN Legal business name Malcolm, Samantha
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 23rd, 2021
Last updated Aug 23rd, 2021 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508532177 NPPES
Georgia MEDICAID 1134257827

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