MEDICARE: LEARNING AND BEHAVIOR

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	251S00000X	Community/Behavioral Health Agency	0813000495	VA
2	251S00000X	Community/Behavioral Health Agency	905	MA

General Provider Information

NPI Number	:	1891168605
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEARNING AND BEHAVIOR

Provider Business Mailing Address
First Line	:	2023 21ST ST N APT 25
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22201-3650
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2023 21ST ST N APT 25
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22201-3650
Country	:	US
Telephone Number	:	202-264-0987
Fax Number	:

Authorized Official
Title or Position	:	EDUCATIONAL PSYCHOLOGIST
Name	:	SARAH D'ELIA
Credential	:
Telephone Number	:	202-264-0987

Provider Enumeration Date	:	11/03/2015
Last Update Date	:	11/03/2015

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