Provider Demographics
NPI:1811861776
Name:BURKS, ASHLEY FAYE (BCBA)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:FAYE
Last Name:BURKS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2062 MATTHEW TALBOT RD
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-3663
Mailing Address - Country:US
Mailing Address - Phone:434-229-8078
Mailing Address - Fax:
Practice Address - Street 1:1608 GRAVES MILL RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-4329
Practice Address - Country:US
Practice Address - Phone:434-363-9515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1-24-74266103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst