Mental Health Services En Espanol LLC
Organization Active NPI Assistant Behavior Analyst · Fairfax, VA
NPI 1811089014 · NPPES record last updated Feb 10, 2025
Key facts
- NPI
- 1811089014
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assistant Behavior Analyst 106E00000X
- Legal business name
- MENTAL HEALTH SERVICES EN ESPANOL LLC
- Practice address
- 10565 Fairfax Blvd Ste 300
Fairfax, VA 22030-3104 - Phone
- (703) 218-6599
- Fax
- (703) 890-7167
- NPI assigned
- Sep 28, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Ignacio Basauri
- Title
- Administrative Director
- Phone
- (703) 218-6599
Practitioners 29
-
Laurel Kokilananda, MS, BCBA
-
Danielle Ramos, M.ED., BCBA, LBA
-
Cooper A Valasek, RBT
-
Van Nguyen, MSW
-
Erika Lanette Portillo, M.ED, LMHP-R
National Provider Directory
Locations
3541 Chain Bridge Rd
Ste 204
Fairfax, VA 22030
Phone (703) 218-6599
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst |
103K00000X | |||
| Assistant Behavior Analyst |
106E00000X | Yes | ||
| Behavior Technician |
106S00000X | |||
| Environmental Modification Occupational Therapy Assistant |
224ZE0001X | |||
| Feeding, Eating & Swallowing Occupational Therapy Assistant |
224ZF0002X | |||
| Occupational Therapist |
225X00000X | |||
| Speech/Language/Hearing Specialist/Technologist |
235500000X | |||
| Audiology Assistant |
2355A2700X | |||
| Speech-Language Assistant |
2355S0801X | |||
| Speech-Language Pathologist |
235Z00000X |
Addresses
Primary practice location
10565 Fairfax Blvd Ste 300
Fairfax, VA 22030-3104
Mailing address
PO Box 3351
Fairfax, VA 22038-3351
Phone (703) 218-6599
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004942442 | Medicaid | VA |
Other names
- Victoria Transcultural Clinical Center LLC
Other providers in Fairfax, VA
- Amanda Mendez
- Claudia Mendez
- Kevin Jonelle Mendez
- Sonia Mendoza
- Tiffany Ann Pastors Mendoza
- Mental Health Therapy Center - Northern Virginia, LLC
- Jose Antonio Mercado
- Saniya Merchant
- Chinelo Mere
- Diana Meredith
All providers in Fairfax, VA · Assistant Behavior Analyst in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.