Individual provider Active NPI

Nicole Rene Rooney, LBS

  • Behavior Analyst
  • Allentown, PA
National Provider Identifier
1023781085
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BH005457 Issued in PA
Practice address
1247 S Cedar Crest Blvd Ste 107
Allentown, PA 18103-6347
Phone
(610) 770-1800
Fax
(610) 770-1805
NPI assigned
Jul 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X BH005457 PA Primary

Addresses

Primary practice location

1247 S Cedar Crest Blvd Ste 107
Allentown, PA 18103-6347

Mailing address

7732 Scenic View Dr
Macungie, PA 18062-2091
Phone (484) 294-7176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
BH005457PAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Blackbird Clinical Services PC CurrentSince Mar 17, 2024 Accepting new patients
Children'S Integrated Center for Success PastSince Aug 1, 2021 Accepting new patients

Locations

1247 S Cedar Crest Blvd
Ste 107
Allentown, PA 18103
Phone (484) 202-0751

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1023781085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7732 SCENIC VIEW DR",
            "city": "MACUNGIE",
            "state": "PA",
            "postal_code": "180622091",
            "telephone_number": "484-294-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1247 S CEDAR CREST BLVD STE 107",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036347",
            "telephone_number": "610-770-1800",
            "fax_number": "610-770-1805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROONEY",
        "first_name": "NICOLE",
        "middle_name": "RENE",
        "credential": "LBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-27",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "BH005457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; 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.