Active NPI
Heather Nicolle, BCBA, LBA
- Behavior Analyst
- Prince Frederick, MD
National Provider Identifier
1083172209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- LBA1152
- Practice address
- 2412 Comptrollers CT
Prince Frederick, MD 20678-4340 - Phone
- (443) 295-3015
- NPI assigned
- Mar 6, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | LBA1152 | MD | Primary |
Addresses
Primary practice location
2412 Comptrollers CT
Prince Frederick, MD 20678-4340
Mailing address
3840 2ND St
North Beach, MD 20714-9733
Phone (443) 366-5971
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
| License | State | Type | Specialty |
|---|---|---|---|
| LBA1152 | MD | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685664000000",
"number": "1083172209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3840 2ND ST",
"city": "NORTH BEACH",
"state": "MD",
"postal_code": "207149733",
"telephone_number": "443-366-5971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2412 COMPTROLLERS CT",
"city": "PRINCE FREDERICK",
"state": "MD",
"postal_code": "206784340",
"telephone_number": "443-295-3015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICOLLE",
"first_name": "HEATHER",
"credential": "BCBA, LBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-06",
"last_updated": "2023-06-02",
"certification_date": "2021-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MD",
"license": "LBA1152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prince Frederick, MD
- Newbridge Spine and Pain Center, LLC
- Newbridge Surgery Center at Prince Frederick, LLC
- Stacey Virginia Newman, LCSW-C
- Stephanie Randolph Newman, MS, LCPC, LCADC
- Nicholson Endodontics LLC
- Karyn A Nicosia
- Ralph Walter Niemann, DDS MS
- Reza Nikpourfard, D.D.S.
- Noah'S Ark ABA LLC
- Susan Jane Noble, D.D.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.