Nicole Anderson, MA, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

2105 E Park St
Cedar Park, TX 78613-4598

Phone

(512) 986-7335

NPI assigned

Mar 18, 2015

Last updated

Nov 5, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1426636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1063805869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 E PARK ST",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786134598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 E PARK ST",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786134598",
            "telephone_number": "512-986-7335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Fairway Dr",
            "address_2": "Ste. 102",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "334411814",
            "country_code": "US",
            "telephone_number": "888-880-9270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "NICOLE",
        "credential": "MA, BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-18",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• An Independent Me
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• Jerald Stuart Andersen, LPC, LMFT
• Eugenie J Anderson, WHNP
• Melinda Anderson, MS, CCC/SLP
• Ryan Robert Anderson
• Andrew KC Wong, M.D., PLLC (Broadview Psychiatry Texas)
• Angela Adkins - Adkins Hollowell Optometry (Clear Choice Eyecare)
• Tracy Lynn Angelocci, MD
• Anil Gudapati DMD PA (Kids Dental Smiles)

• Behavior Analyst in Cedar Park, TX
• Providers in Cedar Park, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.