Samantha H Wilson, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-14-16139

Practice address

4010 Dupont Cir Ste 411
Louisville, KY 40207-4837

Phone

(502) 275-0035

Fax

(502) 275-0034

NPI assigned

Sep 14, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

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.

• Mandran Health PLLC

  • Psychiatry Physician
  • Louisville, KY
  • NPI 1205281862
  NPD Authorized official

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1932416864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR STE 411",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074837",
            "telephone_number": "502-275-0035",
            "fax_number": "502-275-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR STE 411",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074837",
            "telephone_number": "502-275-0035",
            "fax_number": "502-275-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SAMANTHA",
        "middle_name": "H",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-14-16139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca E Wilson
• Robin Wilson
• Roger Dean Wilson
• Samantha Wilson
• Samantha Wilson, MPM, LAT, ATC
• Shari Wilson
• Stephanie K Wilson, B.S.
• Susan Annette Wilson, M.ED
• Susan E Wilson, RDN, LDN
• Sydney Wilson, LCSW

• Behavior Analyst in Louisville, KY
• Providers in Louisville, KY by specialty
• Behavior Analyst in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.