Provider Demographics
NPI:1437689130
Name:LERCARA, SAMANTHA NYCOLE (MS, MA, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:NYCOLE
Last Name:LERCARA
Suffix:
Gender:F
Credentials:MS, MA, BCBA
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:NYCOLE
Other - Last Name:LERCARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7108 S KANNER HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-7462
Mailing Address - Country:US
Mailing Address - Phone:732-491-7469
Mailing Address - Fax:732-491-7469
Practice Address - Street 1:400 E ROYAL LN STE 290
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-3602
Practice Address - Country:US
Practice Address - Phone:732-491-7469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst