Healthcare Provider Details

I. General information

NPI: 1356276471
Provider Name (Legal Business Name): SAMUEL JACOB STREMMEL BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7460 CENTRAL BUSINESS PARK DR
NORFOLK VA
23513-2818
US

IV. Provider business mailing address

5764 AMBERBROOKE ARCH APT 301
VIRGINIA BEACH VA
23464-9109
US

V. Phone/Fax

Practice location:
  • Phone: 757-644-6391
  • Fax:
Mailing address:
  • Phone: 757-769-1880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-66377
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: