Samantha Ackerman, MS, BCBA
Individual provider Active NPI Behavior Analyst · Canton, GA
NPI 1831663947 · NPPES record last updated Mar 16, 2023
Key facts
- NPI
- 1831663947
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1-23-64713 (GA)
- Practice address
- 535 Riverstone Parkway Suite 101
Canton, GA 30114-2566 - Phone
- (855) 942-0995
- NPI assigned
- Jan 11, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Behavior Technician | 106S00000X | |||
| Behavior Analyst | 103K00000X | 1-23-64713 | GA | Yes |
Addresses
Primary practice location
535 Riverstone Parkway Suite 101
Canton, GA 30114-2566
Mailing address
300 International Parkway Suite 200
Lake Mary, FL 32746-5028
Phone (866) 610-0580
Other practice location 1
7318 W Post Rd
Las Vegas, NV 89113-6644
Phone (800) 615-2361
Other practice location 2
725 S Mesa Hills Dr Bldg 3
El Paso, TX 79912-5568
Phone (915) 760-4147
Other providers in Canton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.