Healthcare Provider Details

I. General information

NPI: 1821981424
Provider Name (Legal Business Name): STELLATERRA STUDIO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 04/11/2026
Certification Date: 04/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11789 GREAT OWL CIR
RESTON VA
20194-1172
US

IV. Provider business mailing address

11789 GREAT OWL CIR
RESTON VA
20194-1172
US

V. Phone/Fax

Practice location:
  • Phone: 540-908-7741
  • Fax:
Mailing address:
  • Phone: 540-908-7741
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: HANNAH K JOHNSON
Title or Position: OWNER
Credential: BCBA, LBA
Phone: 540-908-7741