Provider Demographics
NPI:1063975589
Name:ADAMS, JOSEPH KYLE (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:KYLE
Last Name:ADAMS
Suffix:
Gender:M
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 1:601 CARROLL DR
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-2750
Mailing Address - Country:US
Mailing Address - Phone:540-905-6735
Mailing Address - Fax:
Practice Address - Street 1:155 CREEKSIDE LN
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-2447
Practice Address - Country:US
Practice Address - Phone:540-208-7822
Practice Address - Fax:540-208-7853
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133001364103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst