Provider Demographics
NPI:1366924276
Name:SAMSON, CHANDLER N (BCBA)
Entity type:Individual
Prefix:
First Name:CHANDLER
Middle Name:N
Last Name:SAMSON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:CHANDLER
Other - Middle Name:N
Other - Last Name:BARDILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16007 KIRSTEN NICOLE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-7647
Mailing Address - Country:US
Mailing Address - Phone:704-957-7598
Mailing Address - Fax:
Practice Address - Street 1:525 N TRYON STEET
Practice Address - Street 2:SUITE 1600
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-0213
Practice Address - Country:US
Practice Address - Phone:855-832-6727
Practice Address - Fax:772-675-9100
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC274103K00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician