Provider Demographics
NPI:1215641311
Name:MEEKER, KRISTEN NICHOLE (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:NICHOLE
Last Name:MEEKER
Suffix:
Gender:F
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 1:1650 OVERBROOK RD APT B3
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-1303
Mailing Address - Country:US
Mailing Address - Phone:804-238-5896
Mailing Address - Fax:
Practice Address - Street 1:5311 MARKEL RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3008
Practice Address - Country:US
Practice Address - Phone:804-612-1947
Practice Address - Fax:804-612-1955
Is Sole Proprietor?:No
Enumeration Date:2023-01-12
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0134000477106E00000X
VA0133003241103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst