Provider Demographics
NPI:1891116679
Name:LEMONS, SAMANTHA (MS, MA, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:LEMONS
Suffix:
Gender:F
Credentials:MS, MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5575 S. RAINBOW BLVD.
Mailing Address - Street 2:STE 102
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118
Mailing Address - Country:US
Mailing Address - Phone:321-443-9191
Mailing Address - Fax:
Practice Address - Street 1:5755 S. RAINBOW BLVD.
Practice Address - Street 2:SUITE 102
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-4088
Practice Address - Country:US
Practice Address - Phone:321-443-9191
Practice Address - Fax:725-205-2904
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-23
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ228103K00000X
253Z00000X
NVLBA0086103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No253Z00000XAgenciesIn Home Supportive Care