Active NPI
Nicole Visin, MA, BCBA, LBA
- Behavior Analyst
- Benton Harbor, MI
National Provider Identifier
1265071443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 740100146
- Practice address
- 1651 E Nickerson Ave
Benton Harbor, MI 49022-2469 - Phone
- (269) 983-5833
- NPI assigned
- Jan 5, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 740100146 | MI | Primary |
| Behavior Technician | 106S00000X |
Addresses
Primary practice location
1651 E Nickerson Ave
Benton Harbor, MI 49022-2469
Mailing address
1651 E Nickerson Ave
Benton Harbor, MI 49022-2469
Phone (269) 983-5833
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 740100146 | MI | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618444800000",
"number": "1265071443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1651 E NICKERSON AVE",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490222469",
"telephone_number": "269-983-5833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1651 E NICKERSON AVE",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490222469",
"telephone_number": "269-983-5833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VISIN",
"first_name": "NICOLE",
"credential": "MA, BCBA, LBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-05",
"last_updated": "2021-04-15",
"certification_date": "2021-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MI",
"license": "740100146",
"primary": true
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Benton Harbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.