Healthcare Provider Details

I. General information

NPI: 1083486609
Provider Name (Legal Business Name): RICHLIFE BEHAVIOR CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2023
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 SILVER ISLES BLVD APT G
HAMPTON VA
23664-1940
US

IV. Provider business mailing address

12 DECATUR ST
PORTSMOUTH VA
23702-2115
US

V. Phone/Fax

Practice location:
  • Phone: 757-998-0616
  • Fax: 757-998-0616
Mailing address:
  • Phone: 757-998-0616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: MS. SHAVONNE PATRIESE RICHARDSON
Title or Position: OWNER
Credential:
Phone: 757-998-0616