Individual provider · Type 1 NPI

Kimberly Samra, LAC

Mental Health Counselor · Ridgewood, NJ

NPI number 1699374645 Active

Practice location

120 Chestnut St
Ridgewood, NJ 07450-2504

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XAC-GTL-20-01847 (NJ)

Mental Health Counselor: Definition to come...

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About NPI 1699374645

Kimberly Samra, LAC's National Provider Identifier is 1699374645, issued on Oct 21, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Ridgewood, NJ. The record was last updated on Oct 21, 2020.