Stephanie Prouty, BCABA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0134000379 Issued in VA

Practice address

9720 Capital CT Ste 404
Manassas, VA 20110-2052

Phone

(855) 910-1148

NPI assigned

Jun 10, 2019

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 identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Sprouty LLC

  • Behavior Analyst
  • Virginia Beach, VA
  • NPI 1649048042
  NPD Authorized official

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1356900799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 FARRCROFT WAY",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556874",
            "telephone_number": "757-404-8675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9720 CAPITAL CT STE 404",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201102052",
            "telephone_number": "855-910-1148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10300 Courthouse Rd",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "VA",
            "postal_code": "23832",
            "country_code": "US",
            "telephone_number": "855-910-1148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROUTY",
        "first_name": "STEPHANIE",
        "credential": "BCABA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0134000379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0134000379",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "prouty87@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "1157 Farrcroft Way",
            "city": "Virginia Beach",
            "state": "VA",
            "country_code": "US",
            "postal_code": "234556874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychiatric & Counseling Center of Northern Virginia
• PT Solutions LLC
• PT Solutions LLC
• Thomas Arthur Pugh
• Himani Pulivarthi, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.