Healthcare Provider Details
I. General information
NPI: 1114805140
Provider Name (Legal Business Name): ICARE THERAPY VA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/26/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
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
825 W END AVE
NEW YORK NY
10025-5349
US
V. Phone/Fax
- Phone: 303-954-9446
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALEXANDER
DENCIGER
Title or Position: MANAGER
Credential:
Phone: 718-354-7751