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General NPI Number Information
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NPI Number | 1831956069
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Entity Type | Organization
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Legal Business Name | CONNECT N CARE ABA VA LLC
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 04/11/2024
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Provider Practice Location Address
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Address Line | 8609 WESTWOOD CENTER DR
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City | TYSONS
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State | VA
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Zip | 22182-7521
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Country | US
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Telephone | 877-262-2221
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Fax | 877-745-4345
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Provider Business Mailing Address
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Address Line | 1072 MADISON AVE STE 625
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City | LAKEWOOD
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State | NJ
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Zip | 08701-2650
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Country | US
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Telephone | 877-262-2221
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Fax | 877-745-4345
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | F ORZEL
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Credential | BCBA
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Telephone | 704-412-1132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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