Provider Demographics
NPI:1174101646
Name:CHEA, NAYSIM (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:NAYSIM
Middle Name:
Last Name:CHEA
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12727 MCMANUS BLVD STE G
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-4459
Mailing Address - Country:US
Mailing Address - Phone:757-660-5285
Mailing Address - Fax:
Practice Address - Street 1:12727 MCMANUS BLVD STE G
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-4459
Practice Address - Country:US
Practice Address - Phone:757-846-6959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133001961103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0133001961OtherLBA LICENSURE NUMBER