NPIMap

Organization Active NPI

Dom ABA Services LLC

  • Behavior Analyst
  • Chesapeake, VA
National Provider Identifier
1912587585
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
DOM ABA SERVICES LLC
Practice address
611 Station Square CT
Chesapeake, VA 23320-0705
Phone
(757) 752-6225
NPI assigned
Apr 8, 2021
Last updated
Aug 24, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Authorized official

Name
Aleksandra Fentress, BCBANPI 1154813855
Title
Clinical Director
Phone
(757) 895-2673

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 NU Primary

Addresses

Primary practice location

611 Station Square CT
Chesapeake, VA 23320-0705

Mailing address

611 Station Square CT
Chesapeake, VA 23320-0705
Phone (757) 895-2673

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1912587585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 STATION SQUARE CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200705",
            "telephone_number": "757-895-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 STATION SQUARE CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200705",
            "telephone_number": "757-752-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOM ABA SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-08",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "FENTRESS",
        "authorized_official_first_name": "ALEKSANDRA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "757-895-2673",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.