Provider Demographics
NPI:1427871995
Name:KIEFFER, CARLEY (RBT)
Entity type:Individual
Prefix:
First Name:CARLEY
Middle Name:
Last Name:KIEFFER
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7960 DONEGAN DR STE 217
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-8236
Mailing Address - Country:US
Mailing Address - Phone:703-392-6166
Mailing Address - Fax:703-392-3885
Practice Address - Street 1:7960 DONEGAN DR STE 217
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-8236
Practice Address - Country:US
Practice Address - Phone:703-392-6166
Practice Address - Fax:703-392-3885
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23-307755106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician