1396502449 NPI number — SAMANTHA SUE CALCUTT OLENIC PA-C

Table of content: HEATHER ELIZABETH CARCIA LCSW (NPI 1558850297)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396502449 NPI number — SAMANTHA SUE CALCUTT OLENIC PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OLENIC
Provider First Name:
SAMANTHA
Provider Middle Name:
SUE CALCUTT
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CALCUTT
Provider Other First Name:
SAMANTHA
Provider Other Middle Name:
SUE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1396502449
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1211 3RD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEAVER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15009-2530
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-770-7969
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1211 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEAVER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15009-2530
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-770-7969
Provider Business Practice Location Address Fax Number:
724-770-7957
Provider Enumeration Date:
03/05/2024

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X , with the licence number:  MA065376 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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