Provider Demographics
NPI:1417455643
Name:HILLEARY, CHRISTOPHER SEAN (PBSF, BCBA, LBA)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:SEAN
Last Name:HILLEARY
Suffix:
Gender:M
Credentials:PBSF, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10304 SPOTSYLVANIA AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-8605
Mailing Address - Country:US
Mailing Address - Phone:540-710-6085
Mailing Address - Fax:540-710-6447
Practice Address - Street 1:3363 SHAWNEE DR STE 1
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-6301
Practice Address - Country:US
Practice Address - Phone:540-535-0043
Practice Address - Fax:540-535-0011
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000887103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty