Individual provider Active NPI

Harlyn Rodriguez Polanco, M.S.,BCBA,LBA

  • Behavior Analyst
  • North Chesterfield, VA
National Provider Identifier
1427729243
Registry record updated Feb 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0133002030 Issued in VA
Practice address
7400 Beaufont Springs Dr Ste 300
North Chesterfield, VA 23225-5519
Phone
(804) 201-9082
NPI assigned
Sep 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 0133002030 VA Primary

Addresses

Primary practice location

7400 Beaufont Springs Dr Ste 300
North Chesterfield, VA 23225-5519

Mailing address

2929 Gallows Rd Ste 2a
Falls Church, VA 22042-1027
Phone (585) 435-8814

Other practice location 1

2929 Gallows Rd Ste 2A
Falls Church, VA 22042-1027
Phone (585) 435-8814

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0133002030VAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Milestones ABA LLC Behavior Analyst CurrentSince Mar 19, 2023 Accepting new patients
Your Life ABA VA, LLC Behavior Analyst Past Accepting new patients
Galaxy ABA VA LLC Behavior Analyst Past Accepting new patients

Locations

2929 Gallows Rd
Ste 2A
Falls Church, VA 22042
Phone (585) 435-8814

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677283200000",
    "number": "1427729243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 GALLOWS RD STE 2A",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220421027",
            "telephone_number": "585-435-8814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 BEAUFONT SPRINGS DR STE 300",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232255519",
            "telephone_number": "804-201-9082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2929 Gallows Rd Ste 2A",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220421027",
            "country_code": "US",
            "telephone_number": "585-435-8814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ POLANCO",
        "first_name": "HARLYN",
        "credential": "M.S.,BCBA,LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-22",
        "last_updated": "2023-02-25",
        "certification_date": "2023-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133002030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2023; 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.