Individual provider Active NPI

Khadija Azure Sparrow, BEHAVIORAL TECHNICAN

  • Behavior Technician
  • Alexandria, VA
National Provider Identifier
1689530255
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
BACB1455037 Issued in VA
Practice address
5290 Shawnee Rd Ste 220
Alexandria, VA 22312-2381
Phone
(703) 539-8619
NPI assigned
Dec 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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 BACB1455037 VA Primary

Addresses

Primary practice location

5290 Shawnee Rd Ste 220
Alexandria, VA 22312-2381

Mailing address

5290 Shawnee Rd Ste 220
Alexandria, VA 22312-2381
Phone (703) 539-8619

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
BACB1455037VAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1766966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1689530255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5290 SHAWNEE RD STE 220",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223122381",
            "telephone_number": "703-539-8619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5290 SHAWNEE RD STE 220",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223122381",
            "telephone_number": "703-539-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARROW",
        "first_name": "KHADIJA",
        "middle_name": "AZURE",
        "credential": "BEHAVIORAL TECHNICAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-29",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "VA",
            "license": "BACB1455037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; 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.