Active NPI
Nicole Henson
- Behavior Analyst
- Mesa, AZ
National Provider Identifier
1215388376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BA-0232
- Practice address
- 1830 S Alma School Rd
Suite 130
Mesa, AZ 85210-3056 - Phone
- (480) 902-0771
- Fax
- (480) 967-0804
- NPI assigned
- Jun 29, 2016
- 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 | BA-0232 | AZ | Primary |
Addresses
Primary practice location
1830 S Alma School Rd
Suite 130
Mesa, AZ 85210-3056
Mailing address
1848 N 52ND St
Phoenix, AZ 85008-3402
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 |
|---|---|---|---|
| BA-0232 | AZ | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Theraplay4Kidz, LLC | Behavior Analyst | Past | Accepting new patients |
| Total Care ABA Az LLC | Behavior Analyst | Past | Accepting new patients |
Organizations & group practices 2
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
- Scottsdale, AZ
- NPI 1659030955
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467158400000",
"number": "1215388376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1848 N 52ND ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850083402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1830 S ALMA SCHOOL RD",
"address_2": "SUITE 130",
"city": "MESA",
"state": "AZ",
"postal_code": "852103056",
"telephone_number": "480-902-0771",
"fax_number": "480-967-0804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENSON",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-29",
"last_updated": "2016-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "AZ",
"license": "BA-0232",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.