Healthcare Provider Details

I. General information

NPI: 1033893839
Provider Name (Legal Business Name): ABA CENTERS OF VIRGINIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2023
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5904 RICHMOND HWY STE 200
ALEXANDRIA VA
22303-1864
US

IV. Provider business mailing address

542 AMHERST ST UNIT B
NASHUA NH
03063-1016
US

V. Phone/Fax

Practice location:
  • Phone: 561-323-6582
  • Fax: 561-997-1246
Mailing address:
  • Phone: 561-323-6582
  • Fax: 561-997-1246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLEY ESQUIVEL
Title or Position: VP OF OPERATIONS-CREDENTIALING
Credential:
Phone: 728-223-1535