SAMANTHA C WALLACE (Credential# 1125882) is licensed (Licensed Clinical Social Worker) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2018. The license expiration date date is July 31, 2019. The license status is INACTIVE.
SAMANTHA C WALLACE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #58.008580. The credential type is licensed clinical social worker. The effective date is August 1, 2018. The expiration date is July 31, 2019. The business address is 1770 Grand Concourse Apt 14j, Bronx, NY 10457-5569. The current status is inactive.
| Licensee Name | SAMANTHA C WALLACE |
| Credential ID | 1125882 |
| Credential Number | 58.008580 |
| Credential Type | Licensed Clinical Social Worker |
| Business Address |
1770 Grand Concourse Apt 14j Bronx NY 10457-5569 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2014-03-05 |
| Effective Date | 2018-08-01 |
| Expiration Date | 2019-07-31 |
| Refresh Date | 2019-11-03 |
| Street Address | 1770 GRAND CONCOURSE APT 14J |
| City | BRONX |
| State | NY |
| Zip Code | 10457-5569 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sarah Ariana Albert | 12f, Bronx, NY 10457 | Physician/surgeon | ~ |
| Veronica W. Ortiz | 1560 Grand Concourse, Bronx, NY 10457 | Master's Level Social Worker | 2020-01-01 ~ 2020-12-31 |
| Charles Hakikson | 756 E 175th St, Bronx, NY 10457 | Tax Preparer/facilitator Permit | 2020-03-20 ~ 2022-03-31 |
| Edward E Koku | 2059 Washington Ave, Bronx, NY 10457 | Master's Level Social Worker | 2019-12-01 ~ 2020-11-30 |
| Juliana Domfeh | Bronx Lebanon Hospital, Bronx, NY 10457 | Physician Assistant | 2020-02-01 ~ 2021-01-31 |
| Marla R Evans | 2256 Valentine Avenue # 2, Bronx, NY 10457 | Notary Public Appointment | 2016-06-01 ~ 2021-05-31 |
| Roxanne Edwards | 240 East 175th Street, Bronx, NY 10457 | Master's Level Social Worker | 2019-11-01 ~ 2020-10-31 |
| Katherine Anne Santiago | 696 E 182nd St, Bronx, NY 10457 | Registered Nurse | 2019-04-01 ~ 2020-03-31 |
| Procida Realty & Construction Corp | 456 East 173rd Street, Bronx, NY 10457 | Home Improvement Contractor | 2007-12-31 ~ 2008-11-30 |
| Lyndon C Williams | 620 East 178th St Apt #1-b, Bronx, NY 10457 | Home Improvement Contractor | 2006-05-04 ~ 2006-11-30 |
| Find all Licenses in zip 10457 | |||
| City | BRONX |
| Zip Code | 10457 |
| License Type | Licensed Clinical Social Worker |
| License Type + County | Licensed Clinical Social Worker + BRONX |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jeffrey A Wallace | Po Box 111, Centerbrook, CT 06409 | Licensed Clinical Social Worker | 1995-04-25 ~ 1996-04-30 |
| Valerie Wallace | 2 Crampton Rd, Bronxville, NY 10708-4907 | Licensed Clinical Social Worker | 2020-02-01 ~ 2021-01-31 |
| Wallace M Stacy | 31 Fawn Pl, Wilton, CT 06897-1212 | Licensed Clinical Social Worker | 2019-11-01 ~ 2020-10-31 |
| Diana R. P. Wallace | 135 Garfield Pl Apt 526, Cincinnati, OH 45202-5739 | Licensed Clinical Social Worker | 2011-11-01 ~ 2012-10-31 |
| Sylvester D Wallace | 3982 Fireoak Dr, Decatur, GA 30032-3884 | Licensed Clinical Social Worker | ~ |
| Samantha K Case | 112 Gay St, Sharon, CT 06069-2058 | Licensed Clinical Social Worker | 2020-01-01 ~ 2020-12-31 |
| Seth Albert Wallace | 25 Lyon St, New Haven, CT 06511 | Licensed Clinical Social Worker | 2019-10-28 ~ 2020-08-31 |
| Gloria J Searson | 37 Wallace Street, West Haven, CT 06576 | Licensed Clinical Social Worker | ~ |
| Samantha R Yurman | 100 Richards Ave Apt 309, Norwalk, CT 06854-1632 | Licensed Clinical Social Worker | 2020-06-01 ~ 2021-05-31 |
| Samantha R Smalls | 15 April Way, Bloomfield, CT 06002-2805 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
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| Data Provider | Connecticut Department of Consumer Protection |
| Jurisdiction | Connecticut |
| Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).