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General NPI Number Information
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NPI Number | 1518677046
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Entity Type | Organization
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Legal Business Name | BREYTA BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 11/23/2022
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 200 WASHINGTON AVE FL 5
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City | TOWSON
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State | MD
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Zip | 21204-4763
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Country | US
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Telephone | 240-668-4415
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Fax | 240-673-6322
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Provider Business Mailing Address
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Address Line | 505 WINDY KNOLL DR UNIT 323
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City | MOUNT AIRY
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State | MD
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Zip | 21771-6614
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Country | US
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Telephone | 240-668-4415
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Fax | 240-673-6322
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | CARLY ANSON
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Credential |
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Telephone | 240-668-4415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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