Provider Demographics
NPI:1427667096
Name:CLASSIC ABA SERVICES
Entity type:Organization
Organization Name:CLASSIC ABA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHOHREH
Authorized Official - Middle Name:
Authorized Official - Last Name:TOUSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-717-2745
Mailing Address - Street 1:1640 BORO PL FL 4
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-3627
Mailing Address - Country:US
Mailing Address - Phone:703-717-2745
Mailing Address - Fax:
Practice Address - Street 1:7777 LEESBURG PIKE STE 307N
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-2421
Practice Address - Country:US
Practice Address - Phone:703-717-2745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-29
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty