Samantha Young, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-24-76781

Practice address

300 Rice Meadow Way Ste 200
Columbia, SC 29229-8447

Phone

(803) 866-5439

NPI assigned

Apr 28, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Mighty Kidz Services LLC.

  • Behavior Analyst
  • Columbia, SC
  • NPI 1770283707
  NPD (past)

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1164004115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 RICE MEADOW WAY STE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298447",
            "telephone_number": "803-866-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RICE MEADOW WAY STE 200",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292298447",
            "telephone_number": "803-866-5439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3727 Executive Center Dr",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309072398",
            "country_code": "US",
            "telephone_number": "706-842-5330",
            "fax_number": "706-842-5340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "SAMANTHA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-24-76781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Kyzer Young, PHARMD
• Komaleather Young
• Ladonna Young
• Madison Reece Young, RD
• Marisa Young, BA
• Shanell Young
• Shavonna S Young
• Shawntell Young
• Stewart Gregory Young, MD
• Tracy Lynn Young, D.C.

• Behavior Analyst in Columbia, SC
• Providers in Columbia, SC by specialty
• Behavior Analyst in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.