Active NPI
Pamela Lyn Reza, BCBA, LBA
- Behavior Analyst
- Chesapeake, VA
National Provider Identifier
1619518990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 0133001513
- 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, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0133001513 | VA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Treasured Hearts ABA Therapy LLC | Behavior Analyst | Current | Accepting new patients |
| Treasured Hearts ABA LLC | Behavior Analyst | Current | 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.
-
- Behavior Analyst
- Chesapeake, VA
- NPI 1841888047
-
- Behavior Analyst
- Valrico, FL
- NPI 1992681878
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.