Provider Demographics
NPI:1720961402
Name:MCCARROLL, KIERA CAROLYN (RBT)
Entity type:Individual
Prefix:
First Name:KIERA
Middle Name:CAROLYN
Last Name:MCCARROLL
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 RIDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:GIBBSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08026-1419
Mailing Address - Country:US
Mailing Address - Phone:856-816-1485
Mailing Address - Fax:
Practice Address - Street 1:4300 HADDONFIELD RD
Practice Address - Street 2:
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109-3376
Practice Address - Country:US
Practice Address - Phone:856-406-0035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJRBT-24-396159106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician