Healthcare Provider Details

I. General information

NPI: 1740074335
Provider Name (Legal Business Name): NEUROPATH ABA SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13800 COPPERMINE RD # 16939106
HERNDON VA
20171-6163
US

IV. Provider business mailing address

13800 COPPERMINE RD # 16939106
HERNDON VA
20171-6163
US

V. Phone/Fax

Practice location:
  • Phone: 619-362-1401
  • Fax:
Mailing address:
  • Phone: 619-362-1401
  • 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: ASISA POWELL
Title or Position: OWNER, BCBA
Credential: BCBA, LBA
Phone: 619-362-1401