Healthcare Provider Details

I. General information

NPI: 1225946767
Provider Name (Legal Business Name): AVENUES ABA VA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 KING ST FL 5
ALEXANDRIA VA
22314-3132
US

IV. Provider business mailing address

1400 HOOPER AVE
TOMS RIVER NJ
08753-2981
US

V. Phone/Fax

Practice location:
  • Phone: 443-688-9534
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: NAFTALI FIREMAN
Title or Position: COO
Credential:
Phone: 443-688-9534