NPIMap

Organization Active NPI

Awaken Licensed Applied Behavioral Analysis Services PLLC

  • Behavior Analyst
  • Ellicott City, MD
National Provider Identifier
1174097547
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
AWAKEN LICENSED APPLIED BEHAVIORAL ANALYSIS SERVICES PLLC
Practice address
8480 Baltimore National Pike Ste 3210 #126
Ellicott City, MD 21043
Phone
(914) 713-7974
NPI assigned
Jan 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Authorized official

Name
Mrs. Petagaye S. Townsend, MS, BCBA, LBANPI 1497026942
Title
Chief Operating Officer
Phone
(914) 363-8313

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103K00000X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

8480 Baltimore National Pike Ste 3210 #126
Ellicott City, MD 21043

Mailing address

8480 Baltimore National Pike Ste 3210 #126
Ellicott City, MD 21043
Phone (914) 713-7974

National Provider Directory

National Provider Directory

Locations

8480 Baltimore National Pike
Ste 3210
Ellicott City, MD 21043
Phone (914) 363-8313

Practitioners & affiliated clinicians

Practitioners 3

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": "1547769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1174097547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8480 BALTIMORE NATIONAL PIKE STE 3210 #126",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "21043",
            "telephone_number": "914-713-7974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8480 BALTIMORE NATIONAL PIKE STE 3210 #126",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "21043",
            "telephone_number": "914-713-7974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AWAKEN LICENSED APPLIED BEHAVIORAL ANALYSIS SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-18",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A",
        "authorized_official_last_name": "TOWNSEND",
        "authorized_official_first_name": "PETAGAYE",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "914-363-8313",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.