Individual provider Active NPI

Marencia Abunjung Gakeh

  • Behavior Analyst
  • Columbia, MD
National Provider Identifier
1386166445
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-24-74396 Issued in MD
Practice address
9030 Red Branch Rd Ste 100
Columbia, MD 21045-2003
Phone
(877) 504-4141
Fax
(703) 348-3267
NPI assigned
Jul 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-20-117473 MD
Behavior Analyst 103K00000X 1-24-74396 MD Primary

Addresses

Primary practice location

9030 Red Branch Rd Ste 100
Columbia, MD 21045-2003

Mailing address

6713 Terra Alta Dr
Lanham, MD 20706-3747
Phone (240) 645-8022

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

State licenses

LicenseStateTypeSpecialty
RBT-20-117473MDMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1386166445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6713 TERRA ALTA DR",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063747",
            "telephone_number": "240-645-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9030 RED BRANCH RD STE 100",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452003",
            "telephone_number": "877-504-4141",
            "fax_number": "703-348-3267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAKEH",
        "first_name": "MARENCIA",
        "middle_name": "ABUNJUNG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-11",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MD",
            "license": "RBT-20-117473",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MD",
            "license": "1-24-74396",
            "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 16, 2024; 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.