Provider Demographics
NPI:1003377672
Name:KEINZ, RICHARD A JR (BCBA)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:A
Last Name:KEINZ
Suffix:JR
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9669 SPRUCE MOUNTAIN RD LOT 20
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CO
Mailing Address - Zip Code:80118-1200
Mailing Address - Country:US
Mailing Address - Phone:815-978-1452
Mailing Address - Fax:
Practice Address - Street 1:19585 HESS RD STE 6
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3891
Practice Address - Country:US
Practice Address - Phone:720-673-9132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
CO1-21-57044103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician