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General NPI Number Information
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NPI Number | 1912875311
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Entity Type | Organization
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Legal Business Name | C4BEHAVIORLLC
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 116 BELLASERA WAY
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City | RICHMOND HILL
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State | GA
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Zip | 31324-7832
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Country | US
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Telephone | 912-209-4981
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Fax | 912-597-2026
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Provider Business Mailing Address
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Address Line | 116 BELLASERA WAY
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City | RICHMOND HILL
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State | GA
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Zip | 31324-7832
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Country | US
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Telephone | 912-209-4981
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Fax | 912-597-2026
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | DR. SAMANTHA DENEGRI
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Credential | BCBA-D, LBA
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Telephone | 912-209-4981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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