Provider Demographics
NPI:1083151708
Name:SATINE, LIBBEY (M ED, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:LIBBEY
Middle Name:
Last Name:SATINE
Suffix:
Gender:F
Credentials:M ED, BCBA, LBA
Other - Prefix:
Other - First Name:LIBBEY
Other - Middle Name:SATINE
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:619 HOLDCROFT DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-6820
Mailing Address - Country:US
Mailing Address - Phone:540-397-5462
Mailing Address - Fax:
Practice Address - Street 1:619 HOLDCROFT DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-6820
Practice Address - Country:US
Practice Address - Phone:540-397-5462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-20
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133001087103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0133001087OtherVA DEPARTMENT OF HEALTH PROFESSIONS