Active NPI
Tamimullah Azizi
- Behavior Technician
- Woodbridge, VA
National Provider Identifier
1295510154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-23-275375
- Practice address
- 12531 Clipper Dr, Suite #201
Suite #201
Woodbridge, VA 22192-2355 - Phone
- (571) 866-7238
- NPI assigned
- Aug 29, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-23-275375 | VA | Primary |
Addresses
Primary practice location
12531 Clipper Dr, Suite #201
Suite #201
Woodbridge, VA 22192-2355
Mailing address
12531 Clipper Dr Ste 201
Woodbridge, VA 22192-2355
Phone (571) 398-0428
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-23-275375 | VA | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Autism Behavior Therapies | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Behavior Analyst
- Haymarket, VA
- NPI 1770150971
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726790400000",
"number": "1295510154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12531 CLIPPER DR STE 201",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221922355",
"telephone_number": "571-398-0428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12531 CLIPPER DR, SUITE #201",
"address_2": "SUITE #201",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221922355",
"telephone_number": "571-866-7238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZIZI",
"first_name": "TAMIMULLAH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-29",
"last_updated": "2024-09-20",
"certification_date": "2024-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "VA",
"license": "RBT-23-275375",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.