Provider Demographics
NPI:1548054240
Name:AUTISM WELLNESS CENTER INC
Entity type:Organization
Organization Name:AUTISM WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/BCBA
Authorized Official - Prefix:MS
Authorized Official - First Name:BAHIJAH
Authorized Official - Middle Name:
Authorized Official - Last Name:D. SHEIBANEE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA, LBA
Authorized Official - Phone:954-305-7252
Mailing Address - Street 1:18605 KERILL RD
Mailing Address - Street 2:
Mailing Address - City:TRIANGLE
Mailing Address - State:VA
Mailing Address - Zip Code:22172-2064
Mailing Address - Country:US
Mailing Address - Phone:425-350-6611
Mailing Address - Fax:
Practice Address - Street 1:18605 KERILL RD
Practice Address - Street 2:
Practice Address - City:TRIANGLE
Practice Address - State:VA
Practice Address - Zip Code:22172-2064
Practice Address - Country:US
Practice Address - Phone:425-350-6611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No347C00000XTransportation ServicesPrivate Vehicle
No385H00000XRespite Care FacilityRespite Care