Samantha Kavanaugh

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-20-123621 Issued in FL

Practice address

145 E Edgewood Dr
Lakeland, FL 33803-4014

Phone

(863) 619-2809

NPI assigned

Jul 27, 2020

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

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.

• Applied Behavioral Learning Experiences, Inc

  • Community/Behavioral Health Agency
  • Lakeland, FL
  • NPI 1760627905
  NPD
• Applied Behavioral Learning Experiences, Inc.

  • Behavior Analyst
  • Lakeland, FL
  • NPI 1831549674
  NPD (past)

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1497364384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 E EDGEWOOD DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338034014",
            "telephone_number": "863-619-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 E EDGEWOOD DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338034014",
            "telephone_number": "863-619-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-27",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-20-123621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tejaswita Laxman Katta, M.D.
• Jeremy Michael Katzmann, MD
• Heather Elaine Kaufmann, LMHC
• Navneet Kaur
• Scott Jeffrey Kautz Jr., ARNP-BC
• Neal Gary Kavesh, MD
• Kawveh Nofallah DMD PA
• Birungi N. Kayiira, MD
• Kaze Health
• Faeza Rashid Kazmier, MD

• Behavior Technician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.