Individual provider Active NPI

Pamela Lyn Reza, BCBA, LBA

  • Behavior Analyst
  • Chesapeake, VA
National Provider Identifier
1619518990
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0133001513 Issued in VA
Practice address
1108 Eden Way N Ste E
Chesapeake, VA 23320-3339
Phone
(703) 596-9332
Fax
(540) 744-1091
NPI assigned
Oct 8, 2019
Last updated
Apr 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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 0133001513 VA Primary

Addresses

Primary practice location

1108 Eden Way N Ste E
Chesapeake, VA 23320-3339

Mailing address

18025 Grand Prosperity Dr
Venice, FL 34293-4966
Phone (703) 596-2237

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

State licenses

LicenseStateTypeSpecialty
0133001513VAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Treasured Hearts ABA Therapy LLC Behavior Analyst CurrentSince Aug 17, 2025 Accepting new patients
Treasured Hearts ABA LLC Behavior Analyst CurrentSince Apr 28, 2024 Accepting new patients

Locations

1108 Eden Way N
Ste F
Chesapeake, VA 23320
Phone (757) 663-6531

1108 Eden Way N
Ste E
Chesapeake, VA 23320
Phone (703) 596-9332

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1619518990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18025 GRAND PROSPERITY DR",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342934966",
            "telephone_number": "703-596-2237",
            "fax_number": "540-744-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 EDEN WAY N STE E",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203339",
            "telephone_number": "703-596-9332",
            "fax_number": "540-744-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZA",
        "first_name": "PAMELA",
        "middle_name": "LYN",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133001513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.