Provider Demographics
NPI:1417466723
Name:ANCHOR ABA LLC
Entity Type:Organization
Organization Name:ANCHOR ABA LLC
Other - Org Name:ANCHOR ABA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:BLAIR
Authorized Official - Last Name:ROBERSON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA-LBA
Authorized Official - Phone:757-377-8156
Mailing Address - Street 1:724 TERRACE AVE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-4745
Mailing Address - Country:US
Mailing Address - Phone:757-377-8156
Mailing Address - Fax:
Practice Address - Street 1:724 TERRACE AVE
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-4745
Practice Address - Country:US
Practice Address - Phone:757-377-8156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty