MEDICARE: ATLANTIC BEHAVIORAL SPECIALISTS 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	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1396609889
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTIC BEHAVIORAL SPECIALISTS LLC

Provider Business Mailing Address
First Line	:	3610 W OX RD STE 1A
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22033-2302
Country	:	US
Telephone Number	:	443-818-2733
Fax Number	:

Provider Business Practice Location Address
First Line	:	3610 W OX RD STE 1A
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22033-2302
Country	:	US
Telephone Number	:	443-818-2733
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHARLES DADOO
Credential	:
Telephone Number	:	443-818-2733

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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