MEDICARE: JTAIJAH AKINS BCBA, LBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician
2	106E00000X	Assistant Behavior Analyst	0134000641	VA
3	103K00000X	Behavior Analyst	0133005073	VA

General Provider Information

NPI Number	:	1386330058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JTAIJAH AKINS BCBA, LBA

Provider Business Mailing Address
First Line	:	9221 FOREST HILL AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23235-6876
Country	:	US
Telephone Number	:	804-610-0522
Fax Number	:

Provider Business Practice Location Address
First Line	:	9221 FOREST HILL AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23235-6876
Country	:	US
Telephone Number	:	804-610-0522
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2023
Last Update Date	:	04/24/2026

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