Behavioral Therapy and Consultation VA LLC

Organization Active NPI Early Intervention Provider Agency · Dumfries, VA

NPI 1295059418 · NPPES record last updated Mar 17, 2010

Key facts

NPI
1295059418
Entity type
Organization (NPI type 2)
Primary specialty
Early Intervention Provider Agency 252Y00000X
License
1-09-6402 (VA)
Legal business name
BEHAVIORAL THERAPY AND CONSULTATION VA LLC
Practice address
3073 Antrim Cir
Dumfries, VA 22026-3319
Phone
(571) 251-1859
Fax
(703) 441-7814
NPI assigned
Mar 17, 2010
Organization subpart
No

Authorized official

Name
Kelly L Eakin, BCBA
Title
Behavior Analyst
Phone
(571) 251-1859

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Behavioral Therapy and Consultation VA LLC (2 organizations share this tax ID)

Locations

12359 Sunrise Valley Dr
Ste 220
Reston, VA 20191
Phone (301) 620-9762

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 1-09-6402 VA Yes

Addresses

Primary practice location

3073 Antrim Cir
Dumfries, VA 22026-3319

Mailing address

12359 Sunrise Valley Dr
220
Reston, VA 20191-3462
Phone (571) 251-1859

Other providers in Dumfries, VA

All providers in Dumfries, VA · Early Intervention Provider Agency in Virginia

Sources for this page

Verify at the official NPI Registry.