Provider Demographics
NPI:1982586723
Name:FIELDER, ROBERTA (BCABA)
Entity type:Individual
Prefix:
First Name:ROBERTA
Middle Name:
Last Name:FIELDER
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 BROOK PARK PL STE A1
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-2766
Mailing Address - Country:US
Mailing Address - Phone:434-215-3168
Mailing Address - Fax:434-433-9131
Practice Address - Street 1:66 TIMBEROAK CT STE C&D
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-3459
Practice Address - Country:US
Practice Address - Phone:434-215-3168
Practice Address - Fax:434-433-9131
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0134000609106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst