Individual provider · Type 1 NPI

Samantha Kate Moultry, LPCC

Professional Counselor · Dayton, OH

NPI number 1629677307 Active

Practice location

261 Regency Ridge Dr
Dayton, OH 45459-4221

Call (607) 206-2819 Map

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XE.2102113 (OH)
Professional Counselor 101YP2500X6401224846 (MI)

Professional Counselor: Definition to come...

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About NPI 1629677307

Samantha Kate Moultry, LPCC's National Provider Identifier is 1629677307, issued on Oct 22, 2020. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Dayton, OH. The record was last updated on Sep 3, 2025.