Samantha Freeze Bronk, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0133003348 Issued in VA

Practice address

2001 Enterprise Dr
Forest, VA 24551-2653

Phone

(434) 385-1089

NPI assigned

Feb 5, 2024

Last updated

Feb 5, 2024By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Center for Pediatric Counseling

  • Community/Behavioral Health Agency
  • Forest, VA
  • NPI 1659097384

  Behavior Analyst

  NPD
• Center for Pediatric Therapies, Inc.

  • Pediatric Occupational Therapist
  • Danville, VA
  • NPI 1578524278

  Behavior Analyst

  NPD (past)

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1902669732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 ENTERPRISE DR",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245512653",
            "telephone_number": "434-385-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 ENTERPRISE DR",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245512653",
            "telephone_number": "434-385-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONK",
        "first_name": "SAMANTHA",
        "middle_name": "FREEZE",
        "name_prefix": "Mrs.",
        "credential": "LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133003348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tahmina Haque Brady, M.D.
• Dakari Branch
• Kathryn Braswell, LPC
• Chelsea Breiholz
• Suzanna Grace Bright, LPC
• Jarel Brown
• Lucas Brown, PT, DPT
• Marlee Rachel Bryant, DNP, FNP-BC
• Avigyil Buehler
• Ashley Lauren Burks, RPRS-IFPRS,CPRS

• Behavior Analyst in Forest, VA
• Providers in Forest, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.