Healthcare Provider Details

I. General information

NPI: 1902761745
Provider Name (Legal Business Name): SKYBOUND THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2025
Last Update Date: 12/23/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 CRYSTAL DRIVE 6TH FL
ARLINGTON VA
22202
US

IV. Provider business mailing address

1405 S FERN ST UNIT 193
ARLINGTON VA
22202-2810
US

V. Phone/Fax

Practice location:
  • Phone: 201-788-5603
  • Fax:
Mailing address:
  • Phone: 201-788-5603
  • 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: KAREN TILLI
Title or Position: COO
Credential:
Phone: 201-788-5603