Provider Demographics
NPI:1093385270
Name:RIVETTI-SHARPE, SETH ALEXANDER (MA, BCBA, COBA, LBA)
Entity Type:Individual
Prefix:MR
First Name:SETH
Middle Name:ALEXANDER
Last Name:RIVETTI-SHARPE
Suffix:
Gender:M
Credentials:MA, BCBA, COBA, LBA
Other - Prefix:MR
Other - First Name:SETH
Other - Middle Name:A
Other - Last Name:SHARPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, BCBA, COBA, LBA
Mailing Address - Street 1:5630 DOVETREE BLVD
Mailing Address - Street 2:5
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439
Mailing Address - Country:US
Mailing Address - Phone:812-374-7290
Mailing Address - Fax:
Practice Address - Street 1:413 W MONTGOMERY XRD STE 302
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3396
Practice Address - Country:US
Practice Address - Phone:912-712-1094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-21-51007103K00000X
NC493103K00000X
VA0133002563103K00000X
OHCOBA.00994103K00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program