Healthcare Provider Details

I. General information

NPI: 1780502542
Provider Name (Legal Business Name): NORTHERN VIRGINIA BEHAVIORAL THERAPEUTIC CONSULTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 MAYLAND DR STE S
RICHMOND VA
23294-4648
US

IV. Provider business mailing address

8401 MAYLAND DR STE S
RICHMOND VA
23294-4648
US

V. Phone/Fax

Practice location:
  • Phone: 302-495-9650
  • Fax:
Mailing address:
  • Phone: 302-495-9650
  • 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: MAUREEN FOSS
Title or Position: DIRECTOR
Credential: BCBA
Phone: 302-495-9650