NPIMap

Organization Active NPI

Stafford Early Autism Services

  • Behavior Analyst
  • Stafford, VA
National Provider Identifier
1790209526
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
0133000789 Issued in VA
Legal business name
STAFFORD EARLY AUTISM SERVICES
Practice address
538 Apricot Street
Stafford, VA 22554
Phone
(540) 623-4127
Fax
(540) 301-2778
NPI assigned
Aug 2, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Krystal Edmonds, BCBANPI 1194142885
Title
Behavior Analyst
Phone
(540) 623-4127

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 0133000789 VA Primary

Addresses

Primary practice location

538 Apricot Street
Stafford, VA 22554

Mailing address

538 Apricot Street
Stafford, VA 22554
Phone (540) 623-4127

National Provider Directory

National Provider Directory

Locations

2765 Richmond Hwy
Ste 105
Stafford, VA 22554
Phone (540) 699-2381

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1790209526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 APRICOT STREET",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "22554",
            "telephone_number": "540-623-4127",
            "fax_number": "540-301-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 APRICOT STREET",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "22554",
            "telephone_number": "540-623-4127",
            "fax_number": "540-301-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAFFORD EARLY AUTISM SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "EDMONDS",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_title_or_position": "BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "540-623-4127",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133000789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.