Samantha Weldon

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-17-25820 Issued in GA

Practice address

174 Stewart Dr NW
Milledgeville, GA 31061

Phone

(478) 569-6235

Fax

(478) 238-8920

NPI assigned

Apr 14, 2017

Last updated

May 8, 2019By 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

Other names 1

• Samantha Huddleston Former name

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.

• Pure Heart Behavioral Therapy, LLC

  • Community/Behavioral Health Agency
  • Eatonton, GA
  • NPI 1396370862
  NPD (past) Authorized official

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1609300839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 702",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310590702",
            "telephone_number": "478-569-6235",
            "fax_number": "478-238-8920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 STEWART DR NW",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "31061",
            "telephone_number": "478-569-6235",
            "fax_number": "478-238-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELDON",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-14",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "1-17-25820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "HUDDLESTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nancy Cheek Walraven
• Elizabeth Walters, LPC
• Andrea Jenell Webb, LAPC, NCC
• Katherine Hitchcock Webster, MSN, APRN, BC
• Stephanie McNabb Welch, NP-C
• Wellstreet of Georgia PC
• Bobby Dan Wesson Jr., COTA
• Constance Jane Wesson, OTRL,CHT
• Katie Griffin Whipple, MUSIC THERAPIST
• Sharron Whipple, APRN

• Behavior Analyst in Milledgeville, GA
• Providers in Milledgeville, GA by specialty
• Behavior Analyst in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; 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.