Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1235376997 Individual Practitioner Female Practitioner

Dr. Larissa Ann Fedak , EDD CCC-SLP BCBA-D

Behavior Analyst • Lanham, MD

Professional Overview & Biography Verified Profile Summary

Dr. Larissa Fedak, EDD CCC-SLP BCBA-D is a registered healthcare professional specializing in Behavior Analyst in Lanham, MD. Practice services are available at 9500 ANNAPOLIS RD STE B2C2C3 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

9500 Annapolis Rd Ste B2c2c3

Lanham, MD 207062060

Telephone 3018501148
Associated Practice Facility / Clinic
🏢 Renoxx Caregivers, Inc Facility NPI 1528885332

Specialty Benchmarks & Practice Insights

Comparative analytics for Behavior Analyst in Lanham, MD

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 11.0 Yrs
State Avg: 7.0 Yrs
Regional Practice Density
57 Specialists

Practicing in Lanham, MD (1558 Statewide)

Telehealth Adoption Rate
1.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-05-08
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

State License None 1-11-8515

A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.

Speech-Language Pathologist

NUCC Taxonomy Code: 235Z00000X

State License NY 018241

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Speech-Language Pathologist

NUCC Taxonomy Code: 235Z00000X

State License NJ 41YS00572200

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1235376997 (NJ)
Commercial Insurance / Payer ID Bcba-D
1-11-8515

Secondary Practice Locations

4452 Us Highway 421

Pennington Gap, VA 242777972

Phone: 2012849136

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Isatta Sesay

Behavior Technician

NPI 1003316654
Lauren Webb

Behavior Technician

NPI 1003344904
Jattu Kenneh Kanu

Behavior Technician

NPI 1033633292
Maurine Jackson

Behavior Technician

NPI 1043717168
Iyamide Macbailey

Behavior Technician

NPI 1043723679
Tiara Green

Behavior Technician

NPI 1043746811

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

19 Historical Events
📍
Updated Practice Location May 08, 2025

Registered at 9500 ANNAPOLIS RD STE B2C2C3, LANHAM, MD 207062060 (Tel: 3018501148)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 08, 2025

Speech-Language Pathologist (License #018241 in NY)

📍
Updated Practice Location March 16, 2022

Registered at 155 MAIN DUNSTABLE RD STE 150, NASHUA, NH 030603640 (Tel: 6036606306)

📍
Updated Business Mailing Address March 16, 2022

Registered at 4452 US HIGHWAY 421, PENNINGTON GAP, VA 242777972 (Tel: 8558326727)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 16, 2022

Speech-Language Pathologist (License #41YS00572200 in NJ)

📍
Updated Practice Location July 19, 2021

Registered at 125 HALF MILE RD STE 200, RED BANK, NJ 077016749 (Tel: 8558326727)

📍
Updated Business Mailing Address July 19, 2021

Registered at 7108 S KANNER HWY, STUART, FL 349977462 (Tel: 8558326727)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 19, 2021

Speech-Language Pathologist (License #018241 in NY)

📍
Updated Practice Location December 10, 2020

Registered at 1314 NOTTINGHILL LN, TRENTON, NJ 086194015 (Tel: 2012849136)

📍
Updated Business Mailing Address December 10, 2020

Registered at 1314 NOTTINGHILL LN, TRENTON, NJ 086194015 (Tel: 2012849136)

📍
Updated Practice Location August 01, 2019

Registered at 449 S PARK DR APT C8, COLLINGSWOOD, NJ 081081470 (Tel: 2012849136)

📍
Updated Business Mailing Address August 01, 2019

Registered at 449 S PARK DR APT C8, COLLINGSWOOD, NJ 081081470 (Tel: 2012849136)

👤
Provider Name / Credentials Updated August 01, 2019

Recorded as LARISSA FEDAK, EDD CCC-SLP BCBA-D

NPI Profile Active January 16, 2009

NPI status registered as active in NPPES database

📍
Updated Practice Location January 16, 2009

Registered at 7912 RIVER RD, APARTMENT 902, NORTH BERGEN, NJ 070476271 (Tel: 2012849136)

📍
Updated Business Mailing Address January 16, 2009

Registered at 7912 RIVER RD, APARTMENT 902, NORTH BERGEN, NJ 070476271 (Tel: 2012849136)

👤
Provider Name / Credentials Updated January 16, 2009

Recorded as LARISSA FEDAK, MS, CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 16, 2009

Speech-Language Pathologist (License #018241 in NY)

🟢
Initial NPI Registration & Enumeration January 16, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1235376997
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 16, 2009
Last Update: May 08, 2025
Sole Proprietor: Yes

Mailing Address

4452 Us Highway 421

Pennington Gap, VA 242777972

Phone: 8558326727

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.