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

Behavior Analyst β€’ Lanham, MD

Active NPI 1235376997 Individual Practitioner Female Practitioner
Practice location in NPPES

9500 Annapolis Rd Ste B2c2c3
Lanham, MD 207062060

Call 3018501148 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

9500 Annapolis Rd Ste B2c2c3

Lanham, MD 207062060

Telephone 3018501148
Organization at the Same NPPES Address or Phone
Renoxx Caregivers, Inc Facility NPI 1528885332

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Pennington Gap, VA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2009

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Lanham and Maryland

57 active clinicians are listed under Behavior Analyst with a practice address in Lanham, MD (1,553 in Maryland).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Lanham

1.8% of these 57 clinicians have the CMS telehealth indicator.

1.8% of these 57 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-05-08
Behavior Analyst Primary Specialty

NUCC Taxonomy Code: 103K00000X

License # reported to NPPES 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

License # reported to NPPES 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

License # reported to NPPES 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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Maryland Board of Physicians.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
1235376997 (NJ)
Other Identifier Bcba-D
1-11-8515

Secondary Practice Locations

4452 Us Highway 421

Pennington Gap, VA 242777972

Phone: 2012849136

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

19 Historical Events
πŸ“
Updated Practice Location May 08, 2025

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

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

Speech-Language Pathologist (license number reported to NPPES: NY 018241)

πŸ“
Updated Practice Location March 16, 2022

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

πŸ“
Updated Business Mailing Address March 16, 2022

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

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

Speech-Language Pathologist (license number reported to NPPES: NJ 41YS00572200)

πŸ“
Updated Practice Location July 19, 2021

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

πŸ“
Updated Business Mailing Address July 19, 2021

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

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

Speech-Language Pathologist (license number reported to NPPES: NY 018241)

πŸ“
Updated Practice Location December 10, 2020

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

πŸ“
Updated Business Mailing Address December 10, 2020

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

πŸ“
Updated Practice Location August 01, 2019

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

πŸ“
Updated Business Mailing Address August 01, 2019

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

πŸ‘€
Provider Name / Credentials Updated August 01, 2019

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

βœ…
NPI Profile Active January 16, 2009

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) January 16, 2009

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

πŸ“
Business Mailing Address (Initial Record) January 16, 2009

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

πŸ‘€
Provider Name / Credentials (Initial Record) January 16, 2009

Recorded as LARISSA FEDAK, MS, CCC-SLP

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

Speech-Language Pathologist (license number reported to NPPES: NY 018241)

🟒
Initial NPI Registration & Enumeration January 16, 2009

First registered as active Individual Practitioner in NPPES Database.

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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

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.