Organization
AYA BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMANTHA KNOX EDD, LPC, LCPC (OWNER/ CLINICIAN)
(202) 716-1201
Entity
Organization
Contact information
Practice address
1401 MERCANTILE LN STE 500A, LARGO, MD 20774-4301
(202) 716-1201
Mailing address
1401 MERCANTILE LN STE 500A, LARGO, MD 20774-4301
(202) 716-1201
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427585694
—
DC
Enumeration date
03/20/2019
Last updated
06/07/2024
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