Active NPI
Crystal May Sampica-Manor, MS BCBA NYS-LBA
- Behavior Analyst
- West Chazy, NY
National Provider Identifier
1295234979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-15-18047
- Practice address
- 3665 Military Tpke
West Chazy, NY 12992-2807 - Phone
- (518) 493-3558
- NPI assigned
- Feb 7, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 000801-1 | NY | |
| Behavior Analyst | 103K00000X | 1-15-18047 | Primary |
Addresses
Primary practice location
3665 Military Tpke
West Chazy, NY 12992-2807
Mailing address
3665 Military Tpke
West Chazy, NY 12992-2807
Phone (518) 493-3558
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000801-1 | NY | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517961600000",
"number": "1295234979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3665 MILITARY TPKE",
"city": "WEST CHAZY",
"state": "NY",
"postal_code": "129922807",
"telephone_number": "518-493-3558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3665 MILITARY TPKE",
"city": "WEST CHAZY",
"state": "NY",
"postal_code": "129922807",
"telephone_number": "518-493-3558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPICA-MANOR",
"first_name": "CRYSTAL",
"middle_name": "MAY",
"name_prefix": "Mrs.",
"credential": "MS BCBA NYS-LBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-07",
"last_updated": "2018-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NY",
"license": "000801-1",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1-15-18047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Chazy, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.