Samson, Jacqueline Anne

Samson, Jacqueline Anne is an sole proprietor health care provider with primary practice located at 115 Mill St , Belmont MA 02478-1041. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Cognitive & Behavioral is her primary health care specialty. Samson, Jacqueline Anne can be contacted via phone (617) 855-3348.

Contact Information

Primary practice address
115 Mill St Belmont MA 02478-1041
Phone: (617) 855-3348
Fax: (617) 855-2936
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 4522 Massachusetts
Behavioral Health & Social Service Providers / Clinical 103TC0700X 4522 Massachusetts
Behavioral Health & Social Service Providers / Psychologist 103T00000X 4522 Massachusetts

Profile Details

NPI number 1467454652
LBN Legal business name Samson, Jacqueline Anne
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 1st, 2005
Last updated Jul 9th, 2010 - about 15 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 1467454652 NPPES
Massachusetts Other 01950 VALUE OPTIONS
Massachusetts Other W05381 VALUE OPTIONS
Massachusetts Other 001458 VALUE OPTIONS
Massachusetts Other 1858807 VALUE OPTIONS

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