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General NPI Number Information
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NPI Number | 1447813506
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Entity Type | Individual
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Provider Name | NIKITA THADANI
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Gender | Female
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Dates
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Enumeration Date | 04/15/2019
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 4850 MARK CENTER DR
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City | ALEXANDRIA
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State | VA
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Zip | 22311-1882
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Country | US
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Telephone | 703-746-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 13219 COPPERMILL DR
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City | HERNDON
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State | VA
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Zip | 20171-3235
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Country | US
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Telephone | 703-439-4622
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701013666
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License Number State | VA
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