Provider Demographics
NPI:1043701311
Name:BENITEZ, ERICA YAMILEX (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:YAMILEX
Last Name:BENITEZ
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8001 FORBES PL
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-2208
Mailing Address - Country:US
Mailing Address - Phone:703-249-9247
Mailing Address - Fax:
Practice Address - Street 1:8001 FORBES PL
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-2208
Practice Address - Country:US
Practice Address - Phone:703-639-0950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2024-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133002004103K00000X
VA0134000220103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst