Healthcare Provider Details

I. General information

NPI: 1700751617
Provider Name (Legal Business Name): BRIGHT RIDGE BEHAVIOR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

293 PENNY ANN LN
STRASBURG VA
22657-5460
US

IV. Provider business mailing address

293 PENNY ANN LN
STRASBURG VA
22657-5460
US

V. Phone/Fax

Practice location:
  • Phone: 571-420-6276
  • Fax:
Mailing address:
  • Phone: 571-420-6276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: AGNES WHITNEY LYNCH
Title or Position: OWNER
Credential: BCBA, LBA
Phone: 571-420-6276