SPECTRUM AUTISM SERVICES, LLC (NPI# 1184149403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184149403 |
| Entity Type | Organization |
| Organization Name | SPECTRUM AUTISM SERVICES, LLC |
| Practice Address |
12 Monument Dr Stafford VA 22554-8508 |
| Practice Telephone | 5403837133 |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2017-08-08 |
| Authorized Official Name | NANCY DALY (CEO AND CLINICAL DIRECTOR) |
| Authorized Official Telephone | 5403837133 |
| Authorized Official Credential | M.A., BCBA, LBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| Street Address |
12 MONUMENT DR |
| City | STAFFORD |
| State | VA |
| Zip Code | 22554-8508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023679669 | Christopher Lu | Behavior Technician | 12 Monument Dr, Stafford, VA 22554-8508 | 2019-06-25 |
| 1174184949 | Emma Grace Chapple | Behavior Technician | 12 Monument Dr, Stafford, VA 22554-8508 | 2019-06-24 |
| 1700447570 | Lucy Vickery | Behavior Technician | 12 Monument Dr, Stafford, VA 22554-8508 | 2019-06-24 |
| 1255992020 | Michelle Ann Lewis | Behavior Technician | 12 Monument Dr, Stafford, VA 22554-8508 | 2019-06-24 |
| 1164083937 | Lindsay Abigail Sorto | Behavior Technician | 12 Monument Dr, Stafford, VA 22554-8508 | 2019-06-24 |
| 1083270680 | Angela Paulina Paniagua | Behavior Technician | 12 Monument Dr, Stafford, VA 22554-8508 | 2019-05-20 |
| 1619533213 | Tnaja D Briscoe | Behavior Technician | 12 Monument Dr, Stafford, VA 22554-8508 | 2019-05-20 |
| 1629634225 | Hannah Taraschke | Behavior Technician | 12 Monument Dr, Stafford, VA 22554-8508 | 2019-05-20 |
| 1356907950 | Amber Bolen | Behavior Technician | 12 Monument Dr, Stafford, VA 22554-8508 | 2019-05-20 |
| 1790348969 | Christian Scimemi | Behavior Technician | 12 Monument Dr, Stafford, VA 22554-8508 | 2019-04-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699385658 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 1640 Publix Way, Stafford, VA 22554 | 2020-08-05 |
| 1700368156 | Aws Altameemi | Dentist | 392 Garrisonville Road 205, Stafford, VA 22554 | 2018-09-02 |
| 1831680214 | Radka Loucka | Counselor | 2124 Jefferson Davis Highway, Suite 202, Stafford, VA 22554 | 2018-05-22 |
| 1205383718 | Ogiawesome | Non-emergency Medical Transport (VAN) | 109 Chesterbrook Court, Stafford, VA 22554 | 2016-09-01 |
| 1184088502 | Inina Plucer-rosario | Behavioral Analyst | 12 Monument Drive, Stafford, VA 22554 | 2016-04-12 |
| 1528451218 | Insight Psychological Services, Pllc | Counselor | 11 Hope Rd., Suite 213, Stafford, VA 22554 | 2015-03-05 |
| 1194142885 | Krystal Karin Edmonds | Behavioral Analyst | 538 Apricot Street, Stafford, VA 22554 | 2014-03-20 |
| 1851715312 | Maryann Byrne | Counselor | 108 Brandice St, Stafford, VA 22554 | 2014-02-04 |
| 1164857272 | Melissa C Keylor | Counselor | 11 Hope Road, Suite 213, Stafford, VA 22554 | 2013-09-09 |
| 1255777959 | Sophia Rodrigues | Physical Therapist | 2777 Jefferson Davis Hwy, Suite 109, Performance Physical Therapy, Stafford, VA 22554 | 2013-05-21 |
| Find all providers in zip 22554 | ||||
| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639702491 | Rita Anne Martinez | Behavioral Analyst | 8 Brandons Blf, Stafford, VA 22554-5300 | 2020-02-19 |
| 1962032508 | Angel Mack | Behavioral Analyst | 11925 Southwest Fwy Ste 5, Stafford, TX 77477-2300 | 2020-01-23 |
| 1033763594 | Sabrina Gonzales-smith | Behavioral Analyst | 10435 Greenbough Dr. Suite 410, Stafford, TX 77477 | 2019-08-01 |
| 1427529312 | Bianca Gil | Behavioral Analyst | 10435 Geenbough Dr, St 410, Stafford, TX 77477 | 2018-12-17 |
| 1629555818 | Yi Hsuan Dorothy Lu | Behavioral Analyst | 11925 Southwest Fwy Ste 3b, Stafford, TX 77477-2300 | 2018-07-20 |
| 1356828545 | Jocelyn Edith Gomez | Behavioral Analyst | 11925 Southwest Fwy Unit 3b, Stafford, TX 77477-2300 | 2018-07-20 |
| 1154822732 | Celia Kellerman | Behavioral Analyst | 30 Fulton Dr, Stafford, VA 22554-7827 | 2018-02-28 |
| 1902304223 | Teena Castleberry | Behavioral Analyst | 10435 Greenbough Dr Ste 410, Stafford, TX 77477-5000 | 2018-02-01 |
| 1700394038 | Verna Jasmine Birch | Behavioral Analyst | 35 Walpole St Ste 207, Stafford, VA 22554-6546 | 2018-01-22 |
| 1568978310 | Talifa Bailey | Behavioral Analyst | 167 Short Branch Rd, Stafford, VA 22556-4642 | 2017-12-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.