Individual provider Active NPI

Roushan Bagheri

  • Behavior Analyst
  • Fairfax, VA
National Provider Identifier
1740134105
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
11977 Glen Alden Rd
Fairfax, VA 22030-6716
Phone
(571) 234-2998
NPI assigned
Feb 23, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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 VA Primary

Addresses

Primary practice location

11977 Glen Alden Rd
Fairfax, VA 22030-6716

Mailing address

11977 Glen Alden Rd
Fairfax, VA 22030-6716
Phone (571) 234-2998

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

Practice roles

OrganizationSpecialtyStatusNew patients
Blue ABA Center LLC Behavior Analyst Current Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1771804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1740134105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11977 GLEN ALDEN RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306716",
            "telephone_number": "571-234-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11977 GLEN ALDEN RD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220306716",
            "telephone_number": "571-234-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGHERI",
        "first_name": "ROUSHAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-23",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "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 Feb 24, 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.