Basic Information
| Provider Information | |||||||||
| NPI: | 1205343704 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | APEX APPLIED BEHAVIOR SOLUTIONS, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | APEX APPLIED BEHAVIOR SOLUTIONS, LLC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8278 VERNON ST | ||||||||
| Address2: | |||||||||
| City: | MANASSAS | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201094414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038535925 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8278 VERNON ST | ||||||||
| Address2: | |||||||||
| City: | MANASSAS | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201094414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038535925 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2018 | ||||||||
| LastUpdateDate: | 01/05/2018 | ||||||||
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| AuthorizedOfficialLastName: | SOERGEL | ||||||||
| AuthorizedOfficialFirstName: | CARMEL | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7038535925 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | BCBA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 0133000270 | VA | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.