Active NPI
Nicole McClain, BCABA
- Behavior Analyst
- Carmel, IN
National Provider Identifier
1174892962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 0114004
- Practice address
- 172 W Carmel Dr
Carmel, IN 46032-2526 - Phone
- (317) 815-3861
- NPI assigned
- Dec 22, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 0114004 | IN | Primary |
Addresses
Primary practice location
172 W Carmel Dr
Carmel, IN 46032-2526
Mailing address
172 W Carmel Dr
Carmel, IN 46032-2526
Phone (317) 815-3861
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 |
|---|---|---|---|
| 0114004 | IN | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fort Wayne Autism Center Inc | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Behavior Analyst
- Fort Wayne, IN
- NPI 1750664561
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355788800000",
"number": "1174892962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "172 W CARMEL DR",
"city": "CARMEL",
"state": "IN",
"postal_code": "460322526",
"telephone_number": "317-815-3861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "172 W CARMEL DR",
"city": "CARMEL",
"state": "IN",
"postal_code": "460322526",
"telephone_number": "317-815-3861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLAIN",
"first_name": "NICOLE",
"credential": "BCABA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-22",
"last_updated": "2012-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "IN",
"license": "0114004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carmel, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.