Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Larissa Ann Fedak, EDDCCC-SLPBCBA-D

Individual provider Speech-Language Pathologist · NPI 1235376997

Dr. Larissa Ann Fedak, EDDCCC-SLPBCBA-D is a Speech-Language Pathologist in Lanham, Maryland. Practices as a sole proprietor and works from 2 locations. Licensed in New Jersey and New York.

Licensed in
NJ, NY
In the registry since
2009
Specialties on file
3
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Practice location Address checks out

9500 Annapolis Rd Ste B2C2C3
Lanham, MD 20706-2060
Phone: (301) 850-1148
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4452 Us Highway 421, Pennington Gap, VA 24277-7972 — (201) 284-9136

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X · Licence 1-11-8515
Speech-Language Pathologist Taxonomy 235Z00000X · Licence 018241 (NY)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence 41YS00572200 (NJ)

Record details

NPI number1235376997
Entity typeIndividual (Type 1)
GenderFemale
Credentials EDDCCC-SLPBCBA-D
Sole proprietorYes
NPI enumeratedJanuary 16, 2009
Last updated in NPPESMay 8, 2025
Certification dateMay 8, 2025

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