Provider Demographics
NPI:1689152043
Name:CASTELLANO, SARA A (BCBA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:A
Last Name:CASTELLANO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:A
Other - Last Name:CARDONA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3422 BEAUMONT RD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-1525
Mailing Address - Country:US
Mailing Address - Phone:703-801-5836
Mailing Address - Fax:
Practice Address - Street 1:9379 FORESTWOOD LN
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4760
Practice Address - Country:US
Practice Address - Phone:703-801-5836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-29
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1-18-30695103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst