Active NPI
Mallory Rakow
- Behavior Analyst
- Chantilly, VA
National Provider Identifier
1023518669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 3855 Centerview Dr Ste 400B
Chantilly, VA 20151-3285 - Phone
- (571) 554-5730
- NPI assigned
- Feb 20, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
3855 Centerview Dr Ste 400B
Chantilly, VA 20151-3285
Mailing address
1500 S Douglas Rd Ste 230
Coral Gables, FL 33134-4108
Phone (844) 854-1116
Other practice location 1
1800 Alexander Bell Dr Ste 100
Reston, VA 20191-4385
Phone (571) 495-1670
Other practice location 2
46040 Center Oak Plz Ste 150
Sterling, VA 20166-6611
Phone (703) 997-9494
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Your Life ABA VA, LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Behavior Analyst
- New York, NY
- NPI 1023772001
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694044800000",
"number": "1023518669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 S DOUGLAS RD STE 230",
"city": "CORAL GABLES",
"state": "FL",
"postal_code": "331344108",
"telephone_number": "844-854-1116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3855 CENTERVIEW DR STE 400B",
"city": "CHANTILLY",
"state": "VA",
"postal_code": "201513285",
"telephone_number": "571-554-5730"
}
],
"practiceLocations": [
{
"address_1": "1800 Alexander Bell Dr Ste 100",
"address_purpose": "LOCATION",
"city": "Reston",
"state": "VA",
"postal_code": "201914385",
"country_code": "US",
"telephone_number": "571-495-1670",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "46040 Center Oak Plz Ste 150",
"address_purpose": "LOCATION",
"city": "Sterling",
"state": "VA",
"postal_code": "201666611",
"country_code": "US",
"telephone_number": "703-997-9494",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RAKOW",
"first_name": "MALLORY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-20",
"last_updated": "2023-09-07",
"certification_date": "2023-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chantilly, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.