Active NPI
Samaria Ny'Shai Clark
- Behavior Technician
- Garner, NC
National Provider Identifier
1083411425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 640 Timber Dr E Ste 140
Garner, NC 27529-7882 - Phone
- (615) 560-6622
- NPI assigned
- Feb 25, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
640 Timber Dr E Ste 140
Garner, NC 27529-7882
Mailing address
417 Brighton Park Dr Apt 3
Greenville, NC 27834-5982
Phone (252) 326-5622
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740441600000",
"number": "1083411425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 BRIGHTON PARK DR APT 3",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278345982",
"telephone_number": "252-326-5622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 TIMBER DR E STE 140",
"city": "GARNER",
"state": "NC",
"postal_code": "275297882",
"telephone_number": "615-560-6622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "SAMARIA",
"middle_name": "NY'SHAI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-02-25",
"last_updated": "2025-02-25",
"certification_date": "2025-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garner, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.