NPIMap

Organization Active NPI

Evolution Behavioral Health Services, LLC

  • Behavior Analyst
  • Ashburn, VA
National Provider Identifier
1376287276
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
EVOLUTION BEHAVIORAL HEALTH SERVICES, LLC
Practice address
23257 Southdown Manor Ter Unit 101
Ashburn, VA 20148-8176
Phone
(571) 345-8357
NPI assigned
Apr 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Authorized official

Name
Marcelo Lorenzo-Luaces Pico
Title
Director
Phone
(571) 345-8357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

23257 Southdown Manor Ter Unit 101
Ashburn, VA 20148-8176

Mailing address

23257 Southdown Manor Ter Unit 101
Ashburn, VA 20148-8176
Phone (571) 345-8357

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650931200000",
    "number": "1376287276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23257 SOUTHDOWN MANOR TER UNIT 101",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201488176",
            "telephone_number": "571-345-8357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23257 SOUTHDOWN MANOR TER UNIT 101",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201488176",
            "telephone_number": "571-345-8357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION BEHAVIORAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-26",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A",
        "authorized_official_last_name": "LORENZO-LUACES PICO",
        "authorized_official_first_name": "MARCELO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "571-345-8357"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.