Healthcare Provider Details

I. General information

NPI: 1013429877
Provider Name (Legal Business Name): ANDREA BAUMES BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANDREA VERMESI

II. Dates (important events)

Enumeration Date: 11/01/2017
Last Update Date: 09/20/2023
Certification Date: 09/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3040 AVEMORE SQUARE PL
CHARLOTTESVILLE VA
22911-7228
US

IV. Provider business mailing address

3040 AVEMORE SQUARE PL
CHARLOTTESVILLE VA
22911-7228
US

V. Phone/Fax

Practice location:
  • Phone: 434-220-0089
  • Fax: 434-220-0103
Mailing address:
  • Phone: 434-220-0089
  • Fax: 434-220-0103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-43268
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133003081
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: