1396958377 NPI number — BEHAVIORAL RESEARCH ASSOCIATES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396958377 NPI number — BEHAVIORAL RESEARCH ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEHAVIORAL RESEARCH ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BEHAVIORAL RESEARCH ASSOCIATES INC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396958377
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/09/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 492110
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT WASHINGTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20749
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-203-1942
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12201 HOLLY BANK DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FT. WASHINGTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20744
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-203-1942
Provider Business Practice Location Address Fax Number:
301-203-4522
Provider Enumeration Date:
05/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HOUSE
Authorized Official First Name:
ANNETTE
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE ASSISTANT/ACCOUNTANT
Authorized Official Telephone Number:
202-391-4028

Provider Taxonomy Codes

  • Taxonomy code: 261QD1600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 315P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 024474400 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 024475200 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 024476900 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 038771800 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 024473600 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".




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