Stephan Nessim Al-Khateeb, M.ED.

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

11200 Waples Mill Rd Ste 100
Fairfax, VA 22030-7475

Phone

(571) 585-3999

NPI assigned

Feb 18, 2020

Last updated

Mar 4, 2020By 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 2

Addresses

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.

• Axiom Link, Inc.

  dba Achieve Beyond

  • Rehabilitation Clinic/Center
  • Fairfax, VA
  • NPI 1174852867

  Behavior Technician

  NPD (past)

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1164055232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11200 WAPLES MILL RD STE 100",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220307475",
            "telephone_number": "571-585-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 WAPLES MILL RD STE 100",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220307475",
            "telephone_number": "571-585-3999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11240 Waples Mill Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220306078",
            "country_code": "US",
            "telephone_number": "703-237-2219",
            "fax_number": "703-237-2729",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11200 Waples Mill Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220307551",
            "country_code": "US",
            "telephone_number": "703-237-2219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL-KHATEEB",
        "first_name": "STEPHAN",
        "middle_name": "NESSIM",
        "credential": "M.ED.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amani Al-Halali, PA-C
• Al-Juburi Urology, PLLC
• Amer Z Al-Juburi, M.D.
• Rend Al-Khalili, M.D
• Siba Al-Khalili
• Jafar Hamid Al-Mondhiry, M.D.
• Dalya Al-Qaysi, MD
• Ahmed Aladham, DO
• Dina S. Alaeddin, LCGC
• Abdulrahman Alahmad, PT

• Behavior Technician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Behavior Technician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.