Samantha Theresa Glaser, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

004310-01 Issued in NY

Practice address

299 Hallock Ave
Port Jefferson Station, NY 11776-1217

Phone

(631) 473-4284

NPI assigned

Jun 30, 2025

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

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.

• New York Therapy Placement Services Inc.

  • Early Intervention Provider Agency
  • Port Jefferson Station, NY
  • NPI 1558507210
  NPD (past)

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

{
    "created_epoch": "1751241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1790674364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 WILMONT TURN",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117271034",
            "telephone_number": "631-972-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 HALLOCK AVE",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761217",
            "telephone_number": "631-473-4284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASER",
        "first_name": "SAMANTHA",
        "middle_name": "THERESA",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "004310-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Mark Gerber, DDS
• Melissa E Germano, L.AC
• Robert C Giacobbe, D.O.
• Tiffany Giorgio, LICENSED
• Suzanne Giuliani Gimpel, MD
• Nataliya Glazkova, RN
• Rachel Gabrielle Gmelin
• Theodore Goldberg, M.D.
• Robert Jay Goldman, D.D.S.
• Victor James Goldman, LCSW

• Behavior Analyst in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.