Healthcare Provider Details

I. General information

NPI: 1295642791
Provider Name (Legal Business Name): ISAIAH MASSEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 FLORIDA AVE NE APT 508
WASHINGTON DC
20002-6942
US

IV. Provider business mailing address

320 FLORIDA AVE NE APT 508
WASHINGTON DC
20002-6942
US

V. Phone/Fax

Practice location:
  • Phone: 929-280-5788
  • Fax:
Mailing address:
  • Phone: 929-280-5788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberBACB2776384
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: