Samiyah Jamillah Anderson

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

7147 Stonewall Pkwy
Mechanicsvlle, VA 23111-1158

Phone

(804) 557-0881

Fax

(804) 601-3479

NPI assigned

Nov 9, 2022

Last updated

Nov 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• River City ABA

  • Behavior Analyst
  • Mechanicsville, VA
  • NPI 1922519867
  NPD (past)

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

{
    "created_epoch": "1667952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667952000000",
    "number": "1376251298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7143 STONEWALL PKWY",
            "city": "MECHANICSVLLE",
            "state": "VA",
            "postal_code": "23111",
            "telephone_number": "804-557-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7147 STONEWALL PKWY",
            "city": "MECHANICSVLLE",
            "state": "VA",
            "postal_code": "231111158",
            "telephone_number": "804-557-0881",
            "fax_number": "804-601-3479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SAMIYAH",
        "middle_name": "JAMILLAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-09",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandycreek Family Counseling LLC
• BTJS Management
• Rachel Francesca Ferguson
• Megan Elizabeth Melocco
• Margaret Rzasa, LCSW

• Behavior Technician in Mechanicsvlle, VA
• Providers in Mechanicsvlle, VA by specialty
• Behavior Technician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.