Healthcare Provider Details

I. General information

NPI: 1881424091
Provider Name (Legal Business Name): MODERN STEPS ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2024
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15526 SMOKE BOX WAY
WOODBRIDGE VA
22191-5590
US

IV. Provider business mailing address

15526 SMOKE BOX WAY
WOODBRIDGE VA
22191-5590
US

V. Phone/Fax

Practice location:
  • Phone: 571-977-9404
  • Fax:
Mailing address:
  • Phone: 571-866-0640
  • Fax: 571-605-0923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MOHMEET CHOUDHARY
Title or Position: PRESIDENT
Credential: MPH, MBA
Phone: 571-866-0640