Ethan Katz, M.ED, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-18-30640 Issued in NU

Practice address

6563 Edsall Rd
Springfield, VA 22151-4414

Phone

(703) 354-0000

NPI assigned

Aug 13, 2018

Last updated

Aug 13, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Multicultural Clinical Center

  • Community/Behavioral Health Agency
  • Springfield, VA
  • NPI 1487989471
  NPD (past)
• Multicultural Clinical Center

  • Counselor
  • Springfield, VA
  • NPI 1952360612
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1083193890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3819 PRINCE WILLIAM DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313820",
            "telephone_number": "703-346-3185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6563 EDSALL RD",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221514414",
            "telephone_number": "703-354-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6563 Edsall Rd",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "VA",
            "postal_code": "221514414",
            "country_code": "US",
            "telephone_number": "703-354-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KATZ",
        "first_name": "ETHAN",
        "credential": "M.ED, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-13",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": "1-18-30640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIOR ANALYST CERTIFICATION BOARD",
            "identifier": "1-18-30640",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA DEPARTMENT OF HEALTH PROFESSIONALS",
            "identifier": "0133001179",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roberta A Kasman, M.D.
• Aida Kassaye, PHARM D
• Kathleen D. Mosby, PH.D.LLC
• Kathleen Dosby, PH.D. LLC (Explorations LLC)
• Ernest Katz III, M.D.
• Tamanna Kazi
• KCB Play Institute Inc
• Abigail Kearney
• Matthew John Keast, D.P.M.
• Rebecca Sevillano Keegan

• Behavior Analyst in Springfield, VA
• Providers in Springfield, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.