Aya Behavioral Health LLC

Key facts

NPI

1477013258

Entity type

Organization (NPI type 2)

Primary specialty

Mental Health Counselor 101YM0800X

Legal business name

AYA BEHAVIORAL HEALTH LLC

Practice address

1401 Mercantile LN Ste 500a
Largo, MD 20774-4301

Phone

(202) 716-1201

NPI assigned

Mar 20, 2019

Organization subpart

No

Authorized official

Name

Dr. Samantha Knox, EDD, LPC, LCPC NPI 1427585694

Title

Owner/ Clinician

Phone

(202) 716-1201

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

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

• Aya Behavioral Health LLC Mental Health Counselor · Largo, MD · NPI 1225853484
  NPD tax ID

Practitioners 4

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

• Samantha Arleatha-Burns Knox, LPC Mental Health Counselor · Largo, MD · NPI 1427585694
  NPD Authorized official MENTAL HEALTH
• Anah Nisa Alie, MA, LGPC, NCC Mental Health Counselor · Upper Marlboro, MD · NPI 1386511806
  NPD MENTAL HEALTH
• Jessye Alen Barra Heyrana, LGPC Mental Health Counselor · Upper Marlboro, MD · NPI 1477225670
  NPD MENTAL HEALTH
• Marcel E Harris Social Worker · Washington, DC · NPI 1245793421
  NPD (past) SINGLE SPECIALTY

National Provider Directory

Tax ID family

Aya Behavioral Health LLC (2 organizations share this tax ID)

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 7, 2024.

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717718400000",
    "number": "1477013258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 MERCANTILE LN STE 500A",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744301",
            "telephone_number": "202-716-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MERCANTILE LN STE 500A",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744301",
            "telephone_number": "202-716-1201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1629 K St NW Ste 300",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200061631",
            "country_code": "US",
            "telephone_number": "202-716-1201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AYA BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-20",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A",
        "authorized_official_last_name": "KNOX",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "OWNER/ CLINICIAN",
        "authorized_official_telephone_number": "202-716-1201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "EDD, LPC, LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427585694",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Aya Behavioral Health LLC
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• Sam Azargoon, MD
• Jemilat Olapeju Badamas, M.D
• Gerria Marie Ballard, PHARMACIST
• Cecily Barbee, LGSW

All providers in Largo, MD · Mental Health Counselor in Maryland