Angeline Virginia Eaton, BCBA, M. ED.

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

01-17-28494 Issued in CO

Practice address

1651 Old Meadow Rd Ste 600
MC Lean, VA 22102-4389

Phone

(703) 506-0123

Fax

(886) 857-0246

NPI assigned

Jan 16, 2018

Last updated

Mar 2, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Angeline Virginia Gehle Former name

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.

• Oakland University

  dba Graham Health Center

  • Adult Health Nurse Practitioner
  • Rochester, MI
  • NPI 1841447117
  NPD (past)
• Oakland University ABA Clinic

  • Behavior Analyst
  • Rochester, MI
  • NPI 1376915264
  NPD (past)

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1316455181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "472 CAPAC RD",
            "city": "BERLIN",
            "state": "MI",
            "postal_code": "480024202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 OLD MEADOW RD STE 600",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221024389",
            "telephone_number": "703-506-0123",
            "fax_number": "886-857-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "ANGELINE",
        "middle_name": "VIRGINIA",
        "credential": "BCBA, M. ED.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-16",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-17-28494",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CO",
            "license": "01-17-28494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELINE",
            "last_name": "GEHLE",
            "middle_name": "VIRGINIA",
            "credential": "BCBA, M.ED",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lynn Durbin, ATC
• Kaysee Dwyer, PHARMD
• E&T Executive LLC
• Brandon Eason
• Eastern Roots Wellness, PL C
• Jordan Eaton, SLP
• Jessica Echeverry, LPC
• Edmonds Optician of McLean Inc.
• Ednan Mushtaq MD PC
• Roma Edoo-Sowah, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.