TINY TADPOLES BEHAVIORAL SERVICES, LLC (NPI# 1760828321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760828321 |
| Entity Type | Organization |
| Organization Name | TINY TADPOLES BEHAVIORAL SERVICES, LLC |
| Practice Address |
14060 Big Crest Ln Apt 403 Woodbridge VA 22191-5537 |
| Practice Telephone | 5707139112 |
| Mailing Telephone | 5707139112 |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2013-05-21 |
| Authorized Official Name | RECAIRDO DEMETRIUS MANGRUM (DIRECTOR) |
| Authorized Official Telephone | 5707139112 |
| Authorized Official Credential | M.ED., BCBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | VA | Agencies |
| Street Address |
14060 BIG CREST LN APT 403 |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22191-5537 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861021131 | Bailey Orthodontics Pllc | Dentist | 16446 Navigation Drive, Woodbridge, VA 22191 | 2020-04-07 |
| 1417589326 | Meseret Abate | Registered Nurse | 15608 William Bayliss Ct, Woodbridge, VA 22191 | 2020-02-08 |
| 1992279327 | Velocity Urgent Care, LLC | Clinic/Center | 16422 Navigation Dr, Woodbridge, VA 22191 | 2019-01-18 |
| 1821577263 | Maame Gyasiwah Banahene | Registered Nurse | 1812 Featherstone Rd, Woodbridge, VA 22191 | 2018-08-07 |
| 1235617507 | Yaw P. Baidoo | Nutritionist | 14960 Potomac Heights Pl Apt 503, Woodbridge, VA 22191 | 2018-07-30 |
| 1477048452 | Anahita Abazari | Optometrist | 14901 Potomac Town Pl, Suite 120, Woodbridge, VA 22191 | 2018-06-22 |
| 1619490661 | Misti S Gray | Nurse Practitioner | 2296 Optiz Blvd, Suite 440, About Women Ob/gyn, Woodbridge, VA 22191 | 2017-07-21 |
| 1568991974 | Patrice Whilby | Behavior Technician | 2264 York Drive Apt 302, Woodbridge, VA 22191 | 2017-06-08 |
| 1508395245 | Maria Theresa Lee | Registered Nurse | 2028b Opitz Blvd # 22191, Woodbridge, VA 22191 | 2017-06-07 |
| 1861943763 | A1 Home Care, LLC | Home Health | 13928 Jefferson Davis Hwy, Ste # C, Woodbridge, VA 22191 | 2016-10-17 |
| Find all providers in zip 22191 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073127411 | Youth Outreach Services | Community/Behavioral Health | 7050 Lakota Dr Apt 301, Woodbridge, VA 22192-5392 | 2020-09-02 |
| 1770142697 | Well Living LLC | Community/Behavioral Health | 30 Hazel Ter Ste 20, Woodbridge, CT 06525-2240 | 2019-06-13 |
| 1417412818 | Perseverance Counseling Services LLC | Community/Behavioral Health | 1376 Old Bridge Rd # 101-2, Woodbridge, VA 22192-2708 | 2019-02-10 |
| 1467966739 | Clotilda Choh | Community/Behavioral Health | 4740 Pearson Dr, Woodbridge, VA 22193-5413 | 2017-11-25 |
| 1710432653 | Sucess Matters, LLC | Community/Behavioral Health | 14071 Big Crest Ln, 208, Woodbridge, VA 22191-5573 | 2016-08-21 |
| 1508215542 | Cece Counseling, LLC | Community/Behavioral Health | 19b Hazel Ter, Woodbridge, CT 06525-2209 | 2016-06-09 |
| 1679954630 | The Arc Middlesex County | Community/Behavioral Health | 114 Main St Ste C, Woodbridge, NJ 07095-2820 | 2015-06-16 |
| 1972981090 | Lifeline Home Health Inc | Community/Behavioral Health | 4309 Kenwood Dr, Woodbridge, VA 22193 | 2015-05-08 |
| 1033512199 | About Change, LLC | Community/Behavioral Health | 13190 Centerpointe Way, Woodbridge, VA 22193-5286 | 2014-10-03 |
| 1407197353 | Circle of Hope Therapeutic Services, Inc. | Community/Behavioral Health | 15251 Colony Pl Apt 209, Woodbridge, VA 22191-4959 | 2013-03-01 |
| Find all providers in WOODBRIDGE | ||||
| City | WOODBRIDGE |
| Zip Code | 22191 |
Please comment or provide details below to improve the information on TINY TADPOLES BEHAVIORAL SERVICES, LLC.
| 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.