| Doctor Name: | DR. JEFF LOUIS SAMIDE |
| NPI Number: | 1154355139 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ED.D, NCC, MAC, LPC |
| License Number: | PC000035 |
| Business Practice Address: | Rr 3 Box 374c Latrobe, PA - 156509335 |
| Business Phone Number: | 7244233714 |
| Business Fax Number: | 7244232987 |
| Mailing Address: | Rr 3 Box 374c, LATROBE |
| State: | PA |
| Postal Code: | 156509335 |
| Phone Number: | 7244233714 |
| Fax Number: | 7244232987 |
| NPI Enumeration Date: | 07/10/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | PC000035 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |