Nicholas Lea, ASST BEHAVIOR ANALYS

Primary specialty

Assistant Behavior AnalystTaxonomy code 106E00000X

License

ABA-AB-10214291 Issued in OR

Practice address

3535 N Lombard St
Portland, OR 97217-5901

Phone

(800) 273-4292

Fax

(714) 596-6274

NPI assigned

Jan 3, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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.

• Footprints Behavior Interventions

  • Community/Behavioral Health Agency
  • Fountain Valley, CA
  • NPI 1770004830
  NPD
• Footprints Behavioral Interventions, Inc.

  • Early Intervention Provider Agency
  • Santa Ana, CA
  • NPI 1780978858

  Assistant Behavior Analyst

  NPD (past)

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1265949978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11037 WARNER AVE # 339",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084007",
            "telephone_number": "800-273-4292",
            "fax_number": "714-596-6274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 N LOMBARD ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972175901",
            "telephone_number": "800-273-4292",
            "fax_number": "714-596-6274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEA",
        "first_name": "NICHOLAS",
        "credential": "ASST BEHAVIOR ANALYS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-03",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "OR",
            "license": "ABA-AB-10214291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vy Phuong Le, MD
• Ryan Howard Lea-Bou
• Allison D Lea, LCSW
• Christopher Ricard Lea, MD
• Jessica L Lea, LCSW
• Meganne E Leach, PNP
• Robert James Leach
• Faren Leader
• Leaf & Loam Therapy LLC
• David N. Leaf, M.D.

• Assistant Behavior Analyst in Portland, OR
• Providers in Portland, OR by specialty
• Assistant Behavior Analyst in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.