DR. LARISSA ANN FEDAK EDD CCC-SLP BCBA-D - NPI 1235376997

Q: What is Larissa Fedak's NPI number?

The NPI number for Larissa Fedak is 1235376997. It was assigned to this individual provider in the NPPES registry on January 16, 2009.

Q: What is Larissa Fedak's specialty?

The primary specialty registered for this NPI is Behavior Analyst with taxonomy code 103K00000X.

Q: When was this NPI record last updated?

The NPPES record for Larissa Fedak was last updated on May 8, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Dr. Larissa Ann Fedak Edd Ccc-slp Bcba-d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LARISSA ANN FEDAK EDD CCC-SLP BCBA-D (NPI 1235376997) is an individual behavior analyst provider in Lanham, Maryland, licensed in (1-11-8515) and active in the NPI registry since January 2009. She maintains a secondary practice location in Pennington Gap.

NPPES Registry Identity

NPI1235376997

Entity TypeIndividualFemale

Primary Taxonomy103K00000X

Provider Legal NameDR. LARISSA ANN FEDAKCredential: EDD CCC-SLP BCBA-D

Location Address9500 ANNAPOLIS RD STE B2C2C3Lanham, MD 20706-2060

Mailing Address4452 Us Highway 421Pennington Gap, VA 24277-7972 · (855) 832-6727 · Fax (772) 675-9100

Phone(301) 850-1148

Sole ProprietorYes

Enumeration DateJanuary 16, 2009

Last NPPES UpdateMay 8, 20254 updates tracked since enumeration

NPPES CertifiedMay 8, 2025

✔ NPI 1235376997 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyBehavior AnalystBehavioral Health & Social Service Providers

Taxonomy Code103K00000X

License✔ Licensed · 1-11-8515

Definition

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Also ListedSpeech-Language PathologistTaxonomy 235Z00000X · License 018241 (NY), 41YS00572200 (NJ)

9500 ANNAPOLIS RD STE B2C2C3, Lanham, MD 20706

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Secondary Practice Location 1

Location 14452 US Highway 421Pennington Gap, VA 24277-7972 · Phone (201) 284-9136

Other Identifiers 2

Medicaid1235376997NJ

Other1-11-8515Bcba-d

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include WellSense Health Plan.Insurance ›

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OLUWAFOYINSOLAMI FAPOHUNDA

Behavior Analyst