Provider Demographics
NPI:1205483260
Name:NORTHERN VIRGINIA APPLIED BEHAVIOR ANALYSIS, L.L.C.
Entity type:Organization
Organization Name:NORTHERN VIRGINIA APPLIED BEHAVIOR ANALYSIS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED BEHAVIOR ANALYST, LICENSED
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:HOCH
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, BCBA-D,
Authorized Official - Phone:703-987-8928
Mailing Address - Street 1:2528 PAXTON STREET
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192
Mailing Address - Country:US
Mailing Address - Phone:703-987-8928
Mailing Address - Fax:703-454-0971
Practice Address - Street 1:1984 ISSAC NEWTON SQUARE WEST
Practice Address - Street 2:SUITE 204
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190
Practice Address - Country:US
Practice Address - Phone:703-987-8928
Practice Address - Fax:703-454-0971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty