Provider Demographics
NPI:1962940122
Name:KARIEL, KATHLEEN (MT, BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:
Last Name:KARIEL
Suffix:
Gender:F
Credentials:MT, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:943 GLENWOOD STATION LN
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-5714
Mailing Address - Country:US
Mailing Address - Phone:434-923-8252
Mailing Address - Fax:
Practice Address - Street 1:3500 REMSON CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-3508
Practice Address - Country:US
Practice Address - Phone:434-923-8252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-08
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000909103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst