MR. FREDERICK JOHNSON IV (NPI# 1982182960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982182960 |
| Entity Type | Individual |
| Full Name | MR. FREDERICK JOHNSON IV |
| Other Name | MR. FREDDIE JOHNSON IV |
| Practice Address |
10340 Democracy Ln # 102b103 Fairfax VA 22030-2518 |
| Mailing Address |
21600 Oxnard St Ste 1800 Woodland Hills CA 91367-7807 |
| Practice Telephone | 5713860871 |
| Mailing Telephone | 8183452345 |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2018-08-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | VA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164794202 | Frederick Farman Johnson IIi | Contractor | 334 Ne Irving Avenue, Portland, OR 97702 | 2012-02-06 |
| 1619143914 | Frederick Dwayne Johnson Jr. | Radiology | 5 Woods Cv, Little Rock, AR 72210-9108 | 2008-05-06 |
| 1003985524 | Frederick Stephen Johnson | Dentist | 221 W Penn Ave, Ste 213, Cleona, PA 17042 | 2006-11-07 |
| 1295234318 | Frederick Leon Johnson Jr. | Counselor | 1278 W Us Highway 40, Odessa, MO 64076-9612 | 2018-02-04 |
| 1760723159 | Frederick L Johnson | Physical Therapy Assistant | 1205 Sw 29th St, Topeka, KS 66611-1203 | 2013-03-08 |
| 1619174406 | Frederick O Johnson | Dentist | 225 Front St, Binghamton, NY 13905-2424 | 2007-06-27 |
| 1104983360 | Frederick L Johnson | Anesthesiology | 987 Parallel Dr, Lakeport, CA 95453-5702 | 2007-01-03 |
| 1740375971 | Frederick W Johnson | Surgery | 500 Osborne Rd Ne, Suite 200, Fridley, MN 55432-2765 | 2006-10-04 |
| 1376555268 | Frederick G. Johnson | Pediatrics | 1400 E Palomar St, Chula Vista, CA 91913-1800 | 2006-08-12 |
| 1205851672 | Frederick C Johnson | Pediatrics | 12221 Merit Dr, Suite 1610, Dallas, TX 75251-2202 | 2006-07-13 |
| Street Address |
10340 DEMOCRACY LN # 102B103 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22030-2518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902300031 | Kimberly Copeland | Behavior Technician | 10340 Democracy Ln # 102b103, Fairfax, VA 22030-2518 | 2018-03-22 |
| 1609332709 | Widney M Dubuisson | Behavioral Analyst | 10340 Democracy Ln # 102b103, Fairfax, VA 22030-2518 | 2019-02-13 |
| 1629548011 | Busayo Mary Enikanoselu | Behavior Technician | 10340 Democracy Ln # 102b103, Fairfax, VA 22030-2518 | 2018-11-28 |
| 1477033967 | Madeline Culbertson Drenkard | Behavior Technician | 10340 Democracy Ln # 102b103, Fairfax, VA 22030-2518 | 2018-08-15 |
| 1861971418 | Jesus Gutierrez | Behavior Technician | 10340 Democracy Ln # 102b103, Fairfax, VA 22030-2518 | 2018-08-13 |
| 1467931709 | Albert R Ramirez Jr. | Counselor | 10340 Democracy Ln # 102b103, Fairfax, VA 22030-2518 | 2018-08-08 |
| 1467939223 | Hanyun Li | Behavior Technician | 10340 Democracy Ln # 102b103, Fairfax, VA 22030-2518 | 2018-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205449477 | Perry Camp Jr. | Psychologist | 4403 Dixie Hill Rd, Unit 205, Fairfax, VA 22030 | 2020-08-28 |
| 1952940322 | Brightview Fair Oaks, LLC | Alzheimer Center (Dementia Center) | 12725 Lee Highway, Fairfax, VA 22030 | 2020-01-02 |
| 1245871524 | Tori Sprowl | Behavioral Analyst | 10430 Democracy Lane #102b & 103, Fairfax, VA 22030 | 2019-10-08 |
| 1528612124 | Paul Sarigianis | Student in an Organized Health Care Education/Training Program | 10379b Democracy Lane, Fairfax, VA 22030 | 2019-07-31 |
| 1497221303 | Kahak, Inc. | Day Training, Developmentally Disabled Services | 10560 Main Street Suite Ps100, Fairfax, VA 22030 | 2018-10-17 |
| 1689177073 | Shamoona Sharif | Dentist | 11050 Lee Hwy, Fairfax, VA 22030 | 2018-03-13 |
| 1205339538 | Rachael Lee Greene | Social Worker | 4403 Dixie Hill Rd. #206, Fairfax, VA 22030 | 2018-03-13 |
| 1558863027 | Jacqueline Renee Bauer | Skilled Nursing Facility | 10701 Main Street, Fairfax, VA 22030 | 2018-03-01 |
| 1275033607 | Philajo Global LLC | Non-emergency Medical Transport (VAN) | 4521 Billingham Street, Fairfax, VA 22030 | 2018-02-12 |
| 1376050401 | Alexander Harrison | Counselor | 4400 University Drive, Ms 2a2, Fairfax, VA 22030 | 2018-01-10 |
| Find all providers in zip 22030 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891330437 | Sabrina Marie Slack | Behavior Technician | 10430 Democracy Lane #102b, Fairfax, VA 22030-2203 | 2019-11-07 |
| 1932765799 | Alexandra L Wolfe | Behavior Technician | 4139 Halsted St, Fairfax, VA 22033-5527 | 2019-05-16 |
| 1265913610 | Layetta Monique Kerrick | Behavior Technician | 10340 Democracy Ln Ste 103, Fairfax, VA 22030-2518 | 2018-08-23 |
| 1306337217 | Aisha Amadou Konare | Behavior Technician | 10340 Democracy Ln Ste 102b&103, Fairfax, VA 22030-2518 | 2018-05-25 |
| 1902300031 | Kimberly Copeland | Behavior Technician | 10340 Democracy Ln # 102b103, Fairfax, VA 22030-2518 | 2018-03-22 |
| 1285137521 | Leyla Abilova | Behavior Technician | 10340 Democracy Ln # 102b-103, Fairfax, VA 22030-2518 | 2018-03-13 |
| 1003322066 | Jennifer Calderon | Behavior Technician | 10530 Warwick Ave Ste C, Fairfax, VA 22030-3132 | 2017-12-28 |
| 1720594955 | Jacqueline Clark | Behavior Technician | 10530 Warwick Ave Ste C2, Fairfax, VA 22030-3132 | 2017-12-26 |
| 1144739699 | Danielle Christina Sharp | Behavior Technician | 9870a Main Street, Fairfax, VA 22031 | 2017-09-28 |
| 1164944211 | Laura Kapner | Behavior Technician | 11240 Waples Mill Rd Ste 300, Fairfax, VA 22030-6078 | 2017-07-11 |
| Find all providers in FAIRFAX | ||||
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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.