Samantha Pate, LBA, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

2022-007 Issued in AL

Practice address

4778 Overton Rd
Birmingham, AL 35210-3803

Phone

(205) 957-0294

Fax

(205) 957-0298

NPI assigned

Aug 22, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mitchell'S Place, Inc.

  • Behavior Analyst
  • Birmingham, AL
  • NPI 1235263419
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1124675350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4778 OVERTON RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352103803",
            "telephone_number": "205-957-0294",
            "fax_number": "205-957-0298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4778 OVERTON RD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352103803",
            "telephone_number": "205-957-0294",
            "fax_number": "205-957-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATE",
        "first_name": "SAMANTHA",
        "credential": "LBA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AL",
            "license": "2022-007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA BEHAVIOR ANALYST LICENSING BOARD",
            "identifier": "2022-007",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.mitchells-place.com",
            "affiliation": "N",
            "endpointDescription": "Web Address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Web",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Web",
            "address_1": "4778 Overton Rd",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352103803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Passport Health Holdings, LLC
• David Patch, ATC, MED
• Caroline Beesley Pate, O.D.
• Loren Brook Pate, RN
• Raymond L Pate, D.M.D.
• Tori Kirsten Pate
• Aaditya Nimish Patel, DMD
• Aashka Raju Patel, MD
• Adarsh Patel, RN
• Aesha Patel

• Behavior Analyst in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Behavior Analyst in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.