Organization Active NPI

Behavioral Health Associates, LLC

  • Clinical Psychologist
  • Columbia, MD
National Provider Identifier
1063643898
Registry record updated Oct 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
04095 Issued in MD
Legal business name
BEHAVIORAL HEALTH ASSOCIATES, LLC
Practice address
10632 Little Patuxent Pkwy
Suite 343
Columbia, MD 21044-3273
Phone
(410) 997-7373
NPI assigned
Jul 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dayli N. Marrero, PH.D.NPI 1811932338
Title
President
Phone
(410) 997-7373

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 04095 MD Primary

Addresses

Primary practice location

10632 Little Patuxent Pkwy
Suite 343
Columbia, MD 21044-3273

Mailing address

10632 Little Patuxent Pkwy
Suite 343
Columbia, MD 21044-3273
Phone (410) 997-7373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091204000609 MD Part B Supplier - Clinic/Group Practice 2163561093 Receives reassigned benefits from 1 practitioner
Practice locations: Columbia, MD

National Provider Directory

National Provider Directory

Locations

10632 Little Patuxent Pkwy
Ste 310
Columbia, MD 21044
Phone (301) 219-3210

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443657600000",
    "number": "1063643898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10632 LITTLE PATUXENT PKWY",
            "address_2": "SUITE 343",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443273",
            "telephone_number": "410-997-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10632 LITTLE PATUXENT PKWY",
            "address_2": "SUITE 343",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443273",
            "telephone_number": "410-997-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL HEALTH ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-28",
        "last_updated": "2015-10-01",
        "status": "A",
        "authorized_official_last_name": "MARRERO",
        "authorized_official_first_name": "DAYLI",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-997-7373",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.