Healthcare Provider Details

I. General information

NPI: 1467398081
Provider Name (Legal Business Name): CHERRY BLOSSOM COLLECTIVE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 12TH ST N UNIT 202
ARLINGTON VA
22209
US

IV. Provider business mailing address

6312 SEVEN CORNERS CTR # 146
FALLS CHURCH VA
22044-2409
US

V. Phone/Fax

Practice location:
  • Phone: 571-308-1212
  • Fax:
Mailing address:
  • Phone: 571-308-1212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. ASHLEY NICOLE DICARLO
Title or Position: FOUNDER
Credential: BCBA
Phone: 240-925-7223