Provider Demographics
NPI:1770104671
Name:FLIT, SAMANTHA (MSED, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:FLIT
Suffix:
Gender:
Credentials:MSED, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2807 KINGS HWY APT 4C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1800
Mailing Address - Country:US
Mailing Address - Phone:646-874-9103
Mailing Address - Fax:
Practice Address - Street 1:2807 KINGS HWY APT 4C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1800
Practice Address - Country:US
Practice Address - Phone:646-874-9103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-01
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X, 103K00000X
NY.174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty