MEDICARE: ROUSHAN BAGHERI

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		VA

General Provider Information

NPI Number	:	1740134105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROUSHAN BAGHERI

Provider Business Mailing Address
First Line	:	11977 GLEN ALDEN RD
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22030-6716
Country	:	US
Telephone Number	:	571-234-2998
Fax Number	:

Provider Business Practice Location Address
First Line	:	11977 GLEN ALDEN RD
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22030-6716
Country	:	US
Telephone Number	:	571-234-2998
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2026
Last Update Date	:	02/24/2026

Similar Medicare Providers

1225971864 — BLUE ABA CENTER LLC
Practice Location Address:

11977 GLEN ALDEN RD
FAIRFAX, VA
22030-6716

Practice Phone: 571-234-2998
Practice Fax:

1699259812 — DR. TRAVIS DRAKE FLOWER PSY.D., J.D.
Practice Location Address:

10721 MAIN ST STE 203
FAIRFAX, VA
22030-6902

Practice Phone: 302-388-4488
Practice Fax:

1144161100 — CHARLOTTE HOLZEMER
Practice Location Address:

10520 JUDICIAL DR
FAIRFAX, VA
22030-5115

Practice Phone: 703-559-3000
Practice Fax:

1124541313 — DR. CHRISENIA MARIA WHITE ND,LDN, L.AC, DC
Practice Location Address:

10560 MAIN ST STE 510
FAIRFAX, VA
22030-7173

Practice Phone: 571-934-1726
Practice Fax: 800-963-5633

1902748130 — ADITYA KUMAR
Practice Location Address:

11820 LARRY RD
FAIRFAX, VA
22030-5714

Practice Phone: 860-913-7411
Practice Fax:

1528425204 — JODY RITTER DO
Practice Location Address:

10721 MAIN ST STE 205
FAIRFAX, VA
22030-6902

Practice Phone: 571-407-7197
Practice Fax: 571-407-7554

Directions to “ ROUSHAN BAGHERI ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.