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Organization
MIELJADE BEHAVIORAL HEALTH, LLC
Active
Organization
MIELJADE BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GIFTY AMPAW PSYD, BCBA,LABA,LBA (CEO)
(774) 420-8760
Entity
Organization
Contact information
Practice address
6340 SECURITY BLVD STE 100, BALTIMORE, MD 21207-5284
(774) 420-8760
(133) 921-0899
Mailing address
26 UTICA DR, WORCESTER, MA 01603-1623
(774) 420-8760
(339) 210-8992
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
10/23/2023
Last updated
04/29/2026
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