MEDICARE: SAMANTHA ANNE EVANS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	3359	NC
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1639795941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA ANNE EVANS

Provider Business Mailing Address
First Line	:	PO BOX 749
Second Line	:
City	:	BELMONT
State	:	NC
Zip	:	28012-0749
Country	:	US
Telephone Number	:	704-869-2088
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 E MAIN ST
Second Line	:
City	:	MORGANTON
State	:	NC
Zip	:	28655-6040
Country	:	US
Telephone Number	:	828-438-3310
Fax Number	:	828-608-8118

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2020
Last Update Date	:	02/11/2026

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Directions to “ SAMANTHA ANNE EVANS ” Practice Location

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