Susan Jennifer Nicholson, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

82-140 Issued in WI

Practice address

N27W23953 Paul Rd
Suite 206
Pewaukee, WI 53072-6242

Phone

(262) 347-0701

Fax

(262) 347-0705

NPI assigned

May 13, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Susan Jennifer Ankrom Former name

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.

• Pediatric Neuropsychology and Treatment Associates, SC

  • Clinical Child & Adolescent Psychologist
  • Pewaukee, WI
  • NPI 1326265448
  NPD (past)
• Wiebusch & Nicholson Center for Autism, Inc.

  • Community/Behavioral Health Agency
  • Pewaukee, WI
  • NPI 1407073505
  NPD (past)

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

{
    "created_epoch": "1431475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431475200000",
    "number": "1043698897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N27W23953 PAUL RD",
            "address_2": "SUITE 206",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530726242",
            "telephone_number": "262-347-0701",
            "fax_number": "262-347-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N27W23953 PAUL RD",
            "address_2": "SUITE 206",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530726242",
            "telephone_number": "262-347-0701",
            "fax_number": "262-347-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "SUSAN",
        "middle_name": "JENNIFER",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-13",
        "last_updated": "2015-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "82-140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "ANKROM",
            "middle_name": "JENNIFER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Lynn Nemec, RN
• Neurological Wellness Clinic, SC
• New Lifecare Hospitals of Milwaukee LLC (LifeCare Hospitals of Wisconsin)
• Julie I Newman, OTR
• Lisa Marie Newman
• Randall Nickel, PT
• Jeffrey Stuart Niedziela, D.D.S.
• Richard F. Niedziela, D.D.S.
• Michael Thomas Nolte, MD
• Stephen W Noltner, M.D.

• Behavior Analyst in Pewaukee, WI
• Providers in Pewaukee, WI by specialty
• Behavior Analyst in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.