Provider Demographics
NPI:1255865044
Name:CRIPPEN, ROBERT (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:CRIPPEN
Suffix:
Gender:M
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 UNION BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-6514
Mailing Address - Country:US
Mailing Address - Phone:303-989-8169
Mailing Address - Fax:303-984-4366
Practice Address - Street 1:13838 S 46TH PL STE 120
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-7801
Practice Address - Country:US
Practice Address - Phone:480-550-9396
Practice Address - Fax:480-716-8949
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ275103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst