Laurie Beth Samuels, MS, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0133001725 Issued in VA

Practice address

12531 Clipper Dr Ste 203
Woodbridge, VA 22192-2355

Phone

(571) 427-2983

Fax

(571) 408-4966

NPI assigned

Sep 11, 2020

Last updated

Sep 11, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1922613454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12531 CLIPPER DR STE 203",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922355",
            "telephone_number": "571-427-2983",
            "fax_number": "571-408-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12531 CLIPPER DR STE 203",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922355",
            "telephone_number": "571-427-2983",
            "fax_number": "571-408-4966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 John Carlyle St Apt 303",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223146848",
            "country_code": "US",
            "telephone_number": "571-264-1080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "LAURIE",
        "middle_name": "BETH",
        "credential": "MS, BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-11",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133001725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; 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.