Provider Demographics
NPI:1679893366
Name:BECHTEL, SAMANTHA ANN (LISW)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:ANN
Last Name:BECHTEL
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 SCHEID ROAD
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870
Mailing Address - Country:US
Mailing Address - Phone:419-366-6116
Mailing Address - Fax:
Practice Address - Street 1:509 CLEVELAND RD W STE B
Practice Address - Street 2:
Practice Address - City:HURON
Practice Address - State:OH
Practice Address - Zip Code:44839-2717
Practice Address - Country:US
Practice Address - Phone:419-366-6116
Practice Address - Fax:419-386-0984
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0008416104100000X
OHI84161041C0700X
OHI00084161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker