NPIMap

Organization Active NPI

Nicole Vendette, LLC

  • Community/Behavioral Health Agency
  • Port Saint Lucie, FL
National Provider Identifier
1093298564
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
NICOLE VENDETTE, LLC
Practice address
10272 S US Highway 1
Port Saint Lucie, FL 34952-5615
Phone
(407) 947-4675
NPI assigned
Sep 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Authorized official

Name
Mrs. Nicole M Vendette, BCBANPI 1679863237
Title
Owner
Phone
(407) 947-4675

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

10272 S US Highway 1
Port Saint Lucie, FL 34952-5615

Mailing address

3344 NE Sandra Dr
Jensen Beach, FL 34957-3972
Phone (407) 947-4675

Other names 1

  • The Collaborative Behavior Group Doing business as

National Provider Directory

National Provider Directory

Locations

10272 S US Highway 1
Port St Lucie, FL 34952
Phone (772) 872-6940

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1093298564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3344 NE SANDRA DR",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349573972",
            "telephone_number": "407-947-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10272 S US HIGHWAY 1",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349525615",
            "telephone_number": "407-947-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE VENDETTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-11",
        "last_updated": "2024-11-04",
        "certification_date": "2024-10-29",
        "status": "A",
        "authorized_official_last_name": "VENDETTE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-947-4675",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Collaborative Behavior Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.