Individual provider Active NPI

Kenneth Tra

  • Behavior Technician
  • Fairfax, VA
National Provider Identifier
1619873411
Registry record updated Oct 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
10807 Main St Ste 800
Fairfax, VA 22030-4730
Phone
(540) 935-3921
NPI assigned
Oct 19, 2026
Last updated
Oct 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

10807 Main St Ste 800
Fairfax, VA 22030-4730

Mailing address

2255 Jennings St
Woodbridge, VA 22191-4404
Phone (571) 552-7676

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

NPI Registry JSON

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

{
    "created_epoch": "1792368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792368000000",
    "number": "1619873411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 JENNINGS ST",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221914404",
            "telephone_number": "571-552-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10807 MAIN ST STE 800",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304730",
            "telephone_number": "540-935-3921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRA",
        "first_name": "KENNETH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-19",
        "last_updated": "2026-10-19",
        "certification_date": "2026-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "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 Oct 19, 2026; 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.