Patricia M Bagg, CCC-SLP, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0133000547 Issued in VA

Practice address

11736 Sunrise Valley Dr
Reston, VA 20191-1444

Phone

(908) 216-2593

NPI assigned

Jan 29, 2017

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Bagg Therapy Group

  • Speech-Language Pathologist
  • Aldie, VA
  • NPI 1346788189

  Behavior Analyst

  NPD (past) Authorized official

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

{
    "created_epoch": "1485648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1871030817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11736 SUNRISE VALLEY DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911444",
            "telephone_number": "908-216-2593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11736 SUNRISE VALLEY DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201911444",
            "telephone_number": "908-216-2593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGG",
        "first_name": "PATRICIA",
        "middle_name": "M",
        "credential": "CCC-SLP, BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-29",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202007683",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133000547",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Georgia Bachman, LCSW
• Alexander Back, DMD
• Sarah Patricia Baddour, DPT
• Sami Badri, M.D.
• Anushka Bagde, MSW
• Judith Tallant Baggett, NP
• Mirza Baig, M.D.
• Angela Elizabeth Baker Howard, NURSE PRACTITIONER
• Hossein Bakhtar, LPC, LMFT
• Alisa Balderas Martinez

• Behavior Analyst in Reston, VA
• Providers in Reston, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.