Healthcare Provider Details

I. General information

NPI: 1619281896
Provider Name (Legal Business Name): KEPPLEY BEHAVIORAL CONSULTING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2010
Last Update Date: 07/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 MONACO LN
BLANDON PA
19510-9485
US

IV. Provider business mailing address

306 MONACO LN
BLANDON PA
19510-9485
US

V. Phone/Fax

Practice location:
  • Phone: 610-392-6476
  • Fax: 610-926-2685
Mailing address:
  • Phone: 610-392-6476
  • Fax: 610-926-2685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. SHARON KEPPLEY
Title or Position: BOARD CERTIFIED BEHAVIOR ANALYST
Credential: M.ED, BCBA
Phone: 610-392-6476