Jaci Nicole Nichols

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

1518213669 Issued in TX

Practice address

3501 Sheppard Access Rd
Wichita Falls, TX 76306-4235

Phone

(940) 386-2100

Fax

(940) 386-2101

NPI assigned

Aug 3, 2021

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• North Texas Diagnostic Intervention Behavioral Clinic

  • Behavior Analyst
  • Wichita Falls, TX
  • NPI 1902463276

  Behavior Technician

  NPD

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1104590207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 SHEPPARD ACCESS RD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763064235",
            "telephone_number": "940-386-2100",
            "fax_number": "940-386-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 SHEPPARD ACCESS RD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763064235",
            "telephone_number": "940-386-2100",
            "fax_number": "940-386-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JACI",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": "1518213669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "90-0985064",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tuan Anh Nguyen, DMD
• Uyen Nguyen
• Meng Ni, ACUPUNCTURIST
• Niangui Wang MD PLLC
• Carla Jean Nichols, LMT
• Lauren Nichols, LPC
• Tracey Nichols
• Marie Louise Niragira, FNP-C
• Jennifer Leigh Noblin, PH.D.
• Nocona Hospital District

• Behavior Technician in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Behavior Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; 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.