Samara Nicole St Clair, BCABA

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

License

0-23-14848 Issued in VA

Practice address

3024 Forest Hills Cir
Lynchburg, VA 24501-2312

Phone

(866) 565-7222

NPI assigned

Aug 8, 2018

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 identifiers 1

Other names 1

• Samara Nicole Jacobson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Your Life ABA VA, LLC

  • Behavior Analyst
  • New York, NY
  • NPI 1023772001
  NPD

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1609355809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 RIVERLAND RD SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240143610",
            "telephone_number": "866-565-7222",
            "fax_number": "877-734-1914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 FOREST HILLS CIR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012312",
            "telephone_number": "866-565-7222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1314 Riverland Rd SE",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240143610",
            "country_code": "US",
            "telephone_number": "866-565-7222",
            "fax_number": "877-734-1914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ST CLAIR",
        "first_name": "SAMARA",
        "middle_name": "NICOLE",
        "credential": "BCABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-08",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "VA",
            "license": "0-23-14848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609355809",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMARA",
            "last_name": "JACOBSON",
            "middle_name": "NICOLE",
            "credential": "BCABA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sponsored Residential Services of Central Virginia, LLC
• Timothy D Spooner, D.O.
• Parker J Spratling
• Carissa Fitch Sprinkle, DDS
• Blakley Walker Sproles, PA-C
• Gary Houston St. Clair, O.D.
• Valerie H St. John, M.S., CCC-SLP
• Brittany Collins Staley, PHD
• Stamps Haven Group, LLC
• Abbey E Standley

• Assistant Behavior Analyst in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Assistant Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.