Samantha Gambocarto, CASAC Advanced
Counselor, Addiction (Substance Use Disorder) in Syracuse, NY. Individual provider (NPI-1).
NPI number1649020140
StatusActive
Last updated in NPPESMar 26, 2024
Details
- NPI
- 1649020140
- Entity type
- Individual (NPI-1)
- Name
- Samantha Gambocarto
- Credential
- CASAC Advanced
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 26, 2024
- Certification date
- Mar 21, 2024
- Last updated
- Mar 26, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 34086 | NY | Yes |
Other names
- Samantha Hague (Former Name)
Practice location
329 N Salina StSyracuse, NY 13203-1755
Phone 315-471-1564
Mailing address
329 N Salina StSyracuse, NY 13203-1755
Phone 315-471-1564
Other practice locations
329 N Salina St
Syracuse, NY 13203-1755
Syracuse, NY 13203-1755
Phone 315-471-1564
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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