MEDICARE: ABA JOURNEY VA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1215807433
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABA JOURNEY VA LLC

Provider Business Mailing Address
First Line	:	2 CONSTITUTION DR STE 101
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-3479
Country	:	US
Telephone Number	:	757-301-5895
Fax Number	:	470-533-0250

Provider Business Practice Location Address
First Line	:	2 CONSTITUTION DR STE 101
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-3479
Country	:	US
Telephone Number	:	757-301-5895
Fax Number	:	470-533-0250

Authorized Official
Title or Position	:	CEO
Name	:	MR. SHMUELI MILECKI
Credential	:
Telephone Number	:	757-301-5895

Provider Enumeration Date	:	11/11/2025
Last Update Date	:	11/11/2025

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Directions to “ABA JOURNEY VA LLC ” Practice Location

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