NPIMap

Organization Active NPI

Behavioral Therapy & Consultation

  • Behavior Analyst
  • Fairfax, VA
National Provider Identifier
1508165184
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1084254 Issued in VA
Legal business name
BEHAVIORAL THERAPY & CONSULTATION
Practice address
11350 Random Hills Rd Ste 240
Fairfax, VA 22030-6044
Phone
(703) 537-0700
Fax
(703) 537-0688
NPI assigned
Mar 22, 2011
Last updated
Mar 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Authorized official

Name
Kelly Eakin, M.S., BCBA
Title
Director
Phone
(703) 537-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1084254 VA Primary

Addresses

Primary practice location

11350 Random Hills Rd Ste 240
Fairfax, VA 22030-6044

Mailing address

11350 Random Hills Rd Ste 240
Fairfax, VA 22030-6044

National Provider Directory

National Provider Directory
Tax ID family
Behavioral Therapy and Consultation VA LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300752000000",
    "number": "1508165184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 RANDOM HILLS RD STE 240",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11350 RANDOM HILLS RD STE 240",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306044",
            "telephone_number": "703-537-0700",
            "fax_number": "703-537-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL THERAPY & CONSULTATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-22",
        "last_updated": "2011-03-22",
        "status": "A",
        "authorized_official_last_name": "EAKIN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "703-537-0700",
        "authorized_official_credential": "M.S., BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "1084254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; 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.