Provider Demographics
NPI:1164086401
Name:SAMBERG, BRITANY LYNN (BCBA, LABA)
Entity Type:Individual
Prefix:
First Name:BRITANY
Middle Name:LYNN
Last Name:SAMBERG
Suffix:
Gender:F
Credentials:BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 RACHAEL TER
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-1877
Mailing Address - Country:US
Mailing Address - Phone:413-478-3860
Mailing Address - Fax:
Practice Address - Street 1:163 LEAD MINE BROOK RD
Practice Address - Street 2:
Practice Address - City:HARWINTON
Practice Address - State:CT
Practice Address - Zip Code:06791-1315
Practice Address - Country:US
Practice Address - Phone:413-237-5176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1773103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst