Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tidewater Autism Consultation and Therapy, LLC

Organization Behavior Analyst · NPI 1639767981

Tidewater Autism Consultation and Therapy, LLC is a Behavior Analyst in Gloucester, Virginia. Works from 2 locations. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6676 Magnolia Dr
Gloucester, VA 23061-4239
Phone: (757) 604-3394
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6676 Magnolia Dr, Gloucester, VA 23061-4239 — (757) 604-3394

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X

Record details

NPI number1639767981
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joseph Legg — Behavior Analysy · (757) 604-3394
NPI enumeratedJanuary 4, 2021
Last updated in NPPESJanuary 4, 2021
Certification dateJanuary 4, 2021
Mailing address6676 Magnolia Dr, Gloucester, VA 23061-4239

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