Sybil Kettle, RBT

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

License

0134000517 Issued in VA

Practice address

4807 Sadler Rd Ste 300
Glen Allen, VA 23060-6294

Phone

(804) 819-9480

NPI assigned

Jun 1, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Prime Path Behavior Health Consulting, LLC

  • Community/Behavioral Health Agency
  • Richmond, VA
  • NPI 1043175276
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1685577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1063105328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4807 SADLER RD STE 300",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230606294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4807 SADLER RD STE 300",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230606294",
            "telephone_number": "804-819-9480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETTLE",
        "first_name": "SYBIL",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-01",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "VA",
            "license": "0134000517",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Glen Kellems, NP
• Leslie Kelley, FNP
• Meara Kelley
• Kelly Griffith Speech Therapy Services LLC
• Hannah Marshall Kenney
• Robel G Kidanemariam
• Kidmed Inc. (KidMed West End)
• Katelyn Kiley, LPC
• Anne Kim, DPT
• Ji Sun Kim

• Assistant Behavior Analyst in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Assistant Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.