Moore, Samantha

Moore, Samantha is an individual health care provider with primary practice located at 1021 Plantation Ave , Port Allen LA 70767-4034. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Peer Specialist, Other Service Providers / Case Manager/Care Coordinator. Other Service Providers / Peer Specialist is her primary health care specialty. Moore, Samantha can be contacted via phone (225) 460-0509.

Contact Information

Primary practice address
1021 Plantation Ave Port Allen LA 70767-4034
Phone: (225) 460-0509
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X Louisiana
Other Service Providers / Peer Specialist 175T00000X
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1467989103
LBN Legal business name Moore, Samantha
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2017
Last updated Dec 19th, 2023 - about 2 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 1467989103 NPPES
Louisiana MEDICAID 251S00000X

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