Provider Demographics
NPI:1669087227
Name:MORRIS, SAMANTHA KATHLEEN (MA, BCBA)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:KATHLEEN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3578 CHESTNUT HILL AVE
Mailing Address - Street 2:
Mailing Address - City:ATHOL
Mailing Address - State:MA
Mailing Address - Zip Code:01331-9216
Mailing Address - Country:US
Mailing Address - Phone:413-297-8835
Mailing Address - Fax:
Practice Address - Street 1:3578 CHESTNUT HILL AVE
Practice Address - Street 2:
Practice Address - City:ATHOL
Practice Address - State:MA
Practice Address - Zip Code:01331-9216
Practice Address - Country:US
Practice Address - Phone:413-297-8835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-20-41809103K00000X
MA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst