MEDICARE: SPROUT ABA SOLUTIONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1871425009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPROUT ABA SOLUTIONS

Provider Business Mailing Address
First Line	:	5851 COLUMBIA PIKE
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22041-2033
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5851 COLUMBIA PIKE
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22041-2033
Country	:	US
Telephone Number	:	571-999-5474
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	YASMIN ABDULKADIR
Credential	:	PHARMD
Telephone Number	:	571-999-5474

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/04/2026

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