Healthcare Provider Details
I. General information
NPI: 1346031986
Provider Name (Legal Business Name): LITTLE ACORN ABA VA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8401 MAYLAND DR STE 8069
RICHMOND VA
23294-4648
US
IV. Provider business mailing address
42 LENOX DR
LAKEWOOD NJ
08701-7419
US
V. Phone/Fax
- Phone: 732-703-0594
- Fax:
- Phone: 732-703-0594
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHMUEL
S
LANDYNSKI
Title or Position: CEO
Credential:
Phone: 732-703-0594