Individual provider Active NPI

Claudette Delores Samuels

  • Assistant Behavior Analyst
  • Dallas, GA
National Provider Identifier
1194647271
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assistant Behavior AnalystTaxonomy code 106E00000X
Practice address
729 Fairview Dr
Dallas, GA 30157-8833
Phone
(646) 548-4671
NPI assigned
Jul 29, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assistant Behavior Analyst 106E00000X GA Primary

Addresses

Primary practice location

729 Fairview Dr
Dallas, GA 30157-8833

Mailing address

729 Fairview Dr
Dallas, GA 30157-8833
Phone (646) 548-4671

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": "1785283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785283200000",
    "number": "1194647271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 FAIRVIEW DR",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301578833",
            "telephone_number": "646-548-4671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 FAIRVIEW DR",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301578833",
            "telephone_number": "646-548-4671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "CLAUDETTE",
        "middle_name": "DELORES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-07-29",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; 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.