# MR. RICHARD KEITH POLACEK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1841714177
- **Gender:** Man
- **Credential:** LBA, BCBA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | LBA00034 | RI | Yes |

## Other

- **Enumeration date:** 07/28/2017
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1-12-11616 | BEHAVIOR ANALYST CERTIFICATION BOARD | RI |
| 01 | — | LBA00034 | STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS DEPARTMENT OF HEALTH | RI |