Healthcare Provider Details

I. General information

NPI: 1023949625
Provider Name (Legal Business Name): STARLIGHT ABA VA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9211 FOREST HILL AVE STE 200
RICHMOND VA
23235-6877
US

IV. Provider business mailing address

320 ROEBLING ST # 815
BROOKLYN NY
11211-6651
US

V. Phone/Fax

Practice location:
  • Phone: 720-649-5775
  • Fax:
Mailing address:
  • Phone: 720-649-5775
  • 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: ABRAHAM TYBERG
Title or Position: DIRECTOR
Credential:
Phone: 720-649-5775