Tanisha Loren Nowicki, M.ED., LBA, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BEH-000493 Issued in AZ

Practice address

2730 S Val Vista Dr Ste 140
Gilbert, AZ 85295-1679

Phone

(480) 608-4640

NPI assigned

Sep 26, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tanisha Loren Ruesch Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1053962407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 S VAL VISTA DR STE 140",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951679",
            "telephone_number": "480-608-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 S VAL VISTA DR STE 140",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951679",
            "telephone_number": "480-608-4640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4848 E Cactus Rd Ste 940",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852544164",
            "country_code": "US",
            "telephone_number": "480-443-0050",
            "fax_number": "480-443-4018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOWICKI",
        "first_name": "TANISHA",
        "middle_name": "LOREN",
        "credential": "M.ED., LBA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "BEH-000493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANISHA",
            "last_name": "RUESCH",
            "middle_name": "LOREN",
            "credential": "M.ED., LBA, BCBA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Behavior Analyst in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Behavior Analyst in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.