Healthcare Provider Details

I. General information

NPI: 1750258208
Provider Name (Legal Business Name): BUDDING STARS ABA VA1 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2025
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 COMMONWEALTH PL STE 2001061
VIRGINIA BEACH VA
23464-4517
US

IV. Provider business mailing address

349 SUMMIT AVE
CEDARHURST NY
11516-1819
US

V. Phone/Fax

Practice location:
  • Phone: 757-210-7970
  • Fax: 757-866-5587
Mailing address:
  • Phone:
  • 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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ROBERT KLEIN
Title or Position: MANAGER
Credential:
Phone: 516-639-4712