Provider Demographics
NPI:1851055636
Name:ROBERTS, REBECCA PEYTON (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:PEYTON
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:PEYTON
Other - Last Name:KIRKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA, LBA
Mailing Address - Street 1:1200 G ST NW STE 800
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-6705
Mailing Address - Country:US
Mailing Address - Phone:202-794-7159
Mailing Address - Fax:855-568-2494
Practice Address - Street 1:1200 G ST NW STE 800
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-6705
Practice Address - Country:US
Practice Address - Phone:202-794-7159
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2021-10-27
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD103K00000X
MDLBA1120103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
9830OtherALL INSURANCE
MD9830Medicaid