Shenandoah Valley ABA, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

SHENANDOAH VALLEY ABA, LLC

Practice address

1260 Lakeview Dr
Cross Junction, VA 22625-2523

Phone

(757) 553-0798

NPI assigned

Oct 11, 2022

Last updated

Oct 11, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laurimar Mendoza Diaz

Title

Chief Executive Officer

Phone

(757) 553-0617

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665446400000",
    "number": "1386369478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 LAKEVIEW DR",
            "city": "CROSS JUNCTION",
            "state": "VA",
            "postal_code": "226252523",
            "telephone_number": "757-553-0798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 LAKEVIEW DR",
            "city": "CROSS JUNCTION",
            "state": "VA",
            "postal_code": "226252523",
            "telephone_number": "757-553-0798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHENANDOAH VALLEY ABA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-11",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A",
        "authorized_official_last_name": "MENDOZA DIAZ",
        "authorized_official_first_name": "LAURIMAR",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "757-553-0617"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vicky Pennington-Carr
• Laura Ricketts, PFA BBD
• Gennifer Ritenour, MSPAS, PA
• Lisa Rounds, DSW LCSW
• Michelle Maria Sabol, MS
• Kevin Sota
• Kristina Wallace
• Michele White

• Behavior Analyst in Cross Junction, VA
• Providers in Cross Junction, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.