Provider Demographics
NPI:1285904722
Name:KIBLER, RODNEY DALE (PHD, LSP,LPC)
Entity type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:DALE
Last Name:KIBLER
Suffix:
Gender:M
Credentials:PHD, LSP,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 WELSH RUN RD
Mailing Address - Street 2:
Mailing Address - City:RUCKERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22968-2742
Mailing Address - Country:US
Mailing Address - Phone:434-960-0998
Mailing Address - Fax:
Practice Address - Street 1:743 WELSH RUN RD
Practice Address - Street 2:
Practice Address - City:RUCKERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22968-2742
Practice Address - Country:US
Practice Address - Phone:434-960-0998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002516101YM0800X
VA0803000036103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool