| Doctor Name: | MS. SAMANTHA JOAN HUMPHREYS |
| NPI Number: | 1497114565 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCDC |
| License Number: | 13266 |
| Business Practice Address: | 701 E Edinburg Ave Suite E Elsa, TX - 785433002 |
| Business Phone Number: | 9565672026 |
| Business Fax Number: | 9565672027 |
| Mailing Address: | 701 E Edinburg Ave, Suite E ELSA |
| State: | TX |
| Postal Code: | 78543 |
| Phone Number: | 9565672026 |
| Fax Number: | 9565672027 |
| NPI Enumeration Date: | 02/18/2016 |
| NPI Last Update Date: | 02/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 13266 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |