NPIMap

Individual provider Active NPI

Soraya Dos Santos

  • Behavior Analyst
  • Capitol Heights, MD
National Provider Identifier
1639433436
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-06-2876 Issued in VA
Practice address
4119 Ellis St
Capitol Heights, MD 20743-5756
Phone
(301) 219-8190
Fax
(877) 219-8773
NPI assigned
Jun 27, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-06-2876 VA Primary

Addresses

Primary practice location

4119 Ellis St
Capitol Heights, MD 20743-5756

Mailing address

8040 Ians Aly
Laurel, MD 20724-6133

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avance Behavioral Advantage LLC Behavior Analyst CurrentSince Dec 3, 2023 Accepting new patients
Attain ABA NE LLC Behavior Analyst Past Accepting new patients
The Sparks Group, LLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1639433436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8040 IANS ALY",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207246133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4119 ELLIS ST",
            "city": "CAPITOL HEIGHTS",
            "state": "MD",
            "postal_code": "207435756",
            "telephone_number": "301-219-8190",
            "fax_number": "877-219-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOS SANTOS",
        "first_name": "SORAYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "1-06-2876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Capitol Heights, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.