=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225996705
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARAVAN ABA THERAPY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/13/2026
-----------------------------------------------------
Last Update Date | 01/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 800 CORPORATE DR SUITE 301
-----------------------------------------------------
City | STAFFORD
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22554
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-870-3435
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14497 POTOMAC MILLS RD # 1214
-----------------------------------------------------
City | WOODBRIDGE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22192-6807
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-870-3435
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | LAWORE MANGAL
-----------------------------------------------------
Credential | MANAGER
-----------------------------------------------------
Telephone | 540-764-8227
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------