Provider Demographics
NPI:1073058467
Name:RAPHAELIDIS, JANUS (BCBA, LBA)
Entity type:Individual
Prefix:MR
First Name:JANUS
Middle Name:
Last Name:RAPHAELIDIS
Suffix:
Gender:
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7120 SAMUEL MORSE DR STE 150
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-3420
Mailing Address - Country:US
Mailing Address - Phone:443-293-2314
Mailing Address - Fax:
Practice Address - Street 1:7120 SAMUEL MORSE DR STE 150
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3420
Practice Address - Country:US
Practice Address - Phone:443-293-2314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-21
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLBA372103K00000X
MD0000000000000000000106S00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician