Samantha Kimmerer, BCABA, LABA

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

License

7402000149 Issued in MI

Practice address

2549 Jolly Rd Ste 380
Okemos, MI 48864-3680

Phone

(989) 217-8061

NPI assigned

Sep 21, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Samantha Lowery Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• ABA Pathways, LLC

  • Behavior Analyst
  • Ann Arbor, MI
  • NPI 1770838468
  NPD (past)

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1568078004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S DOUGLAS RD STE 230",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344108",
            "telephone_number": "844-244-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2549 JOLLY RD STE 380",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643680",
            "telephone_number": "989-217-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMMERER",
        "first_name": "SAMANTHA",
        "credential": "BCABA, LABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "MI",
            "license": "0-22-13745",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "MI",
            "license": "7402000149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "LOWERY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Khan and Associates PA
• Shadman Khan
• Tahrima Khanom
• Sema Khraishi
• Linda A Kimball, LMSW
• Brittany King, LLMSW
• Erin King
• Michael T King, LMSW
• Andrew Kingstrom
• Emily Anne Kinville, PA-C

• Assistant Behavior Analyst in Okemos, MI
• Providers in Okemos, MI by specialty
• Assistant Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.