Recairdo Demetrius Mangrum, PH.D.

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-12-12387

Practice address

500 Redland CT
Owings Mills, MD 21117-3264

Phone

(201) 979-1336

NPI assigned

Jan 31, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Tiny Tadpoles Behavioral Services, LLC

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  • NPI 1760828321
  NPD Authorized official
• Breakthru Autism Services

  • Community/Behavioral Health Agency
  • Manassas, VA
  • NPI 1386035079
  NPD (past)

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

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1609115369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 BELGROVE DR",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070321507",
            "telephone_number": "201-979-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 REDLAND CT",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211173264",
            "telephone_number": "201-979-1336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2235 Coventry Rd",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176013032",
            "country_code": "US",
            "telephone_number": "570-713-9112",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1693 Crown Ave",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176016310",
            "country_code": "US",
            "telephone_number": "717-488-3819",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9720 Capital Ct Ste 404",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201102052",
            "country_code": "US",
            "telephone_number": "571-232-3691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGRUM",
        "first_name": "RECAIRDO",
        "middle_name": "DEMETRIUS",
        "name_prefix": "Mr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-31",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MD",
            "license": "LBA972",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-12-12387",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "BH000158",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133000226",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisa Perle Mandel, O.D.
• Bruce P. Mandel, D.D.S.
• Ira Mandell, M.D.
• Jonathan Scott Mandras, D.D.S.
• Genevieve Manger
• Tasha Manigo-Bizzell, LDN
• Rachel Manning, MS, SLP-CF
• Emelia Manu, RN
• Sarah C Manuba
• Chelsea F Manzon, LCSW-C

• Behavior Analyst in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Behavior Analyst in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; 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.