Healthcare Provider Details

I. General information

NPI: 1740105014
Provider Name (Legal Business Name): BEAMING KIDS VA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11815 FOUNTAIN WAY STE 300
NEWPORT NEWS VA
23606-4448
US

IV. Provider business mailing address

11815 FOUNTAIN WAY STE 300
NEWPORT NEWS VA
23606-4448
US

V. Phone/Fax

Practice location:
  • Phone: 410-401-0042
  • Fax: 410-216-1069
Mailing address:
  • Phone: 410-401-0042
  • Fax: 410-216-1069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AVRAHAM YORMARK
Title or Position: DIRECTOR
Credential:
Phone: 410-401-0042