Provider Demographics
NPI:1497297568
Name:BOEVING, SAMANTHA LEANNE DONALS (MS, BCBA)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:LEANNE DONALS
Last Name:BOEVING
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:MS
Other - First Name:SAMANTHA
Other - Middle Name:LEANNE
Other - Last Name:DONALS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1725 RIVER ROCK ARCH
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-6155
Mailing Address - Country:US
Mailing Address - Phone:360-362-3718
Mailing Address - Fax:
Practice Address - Street 1:2076 S INDEPENDENCE BLVD STE B
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23453-4779
Practice Address - Country:US
Practice Address - Phone:757-622-7272
Practice Address - Fax:757-271-0618
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2025-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1-25-79348103K00000X
VA106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst