Provider Demographics
NPI:1306397526
Name:POPIO, SAMANTHA (BCBA)
Entity Type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:
Last Name:POPIO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4949 GALAXY PKWY STE W
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5959
Mailing Address - Country:US
Mailing Address - Phone:440-856-6735
Mailing Address - Fax:
Practice Address - Street 1:484 WOODBINE CIR
Practice Address - Street 2:
Practice Address - City:MAYFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44143-1525
Practice Address - Country:US
Practice Address - Phone:440-856-6735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-16-23647103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst