Provider Demographics
NPI:1013807130
Name:MCGRAW, IDA CHARLOTTE (LBA, BCBA)
Entity type:Individual
Prefix:
First Name:IDA
Middle Name:CHARLOTTE
Last Name:MCGRAW
Suffix:
Gender:F
Credentials:LBA, BCBA
Other - Prefix:
Other - First Name:IDA
Other - Middle Name:CHARLOTTE
Other - Last Name:BASILIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16 RIVER VIEW DR
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:VA
Mailing Address - Zip Code:24482-2541
Mailing Address - Country:US
Mailing Address - Phone:804-517-9761
Mailing Address - Fax:
Practice Address - Street 1:1751 SHUTTERLEE MILL RD
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-1709
Practice Address - Country:US
Practice Address - Phone:540-332-3934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133004375103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst