Nicole Elizabeth Radzilowicz, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

2597 Issued in MA

Practice address

600 W Cummings Park Ste 1800
Woburn, MA 01801-6433

Phone

(339) 227-4000

NPI assigned

Sep 20, 2016

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1295283190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 WATER ST # 200",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024724611",
            "telephone_number": "617-923-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W CUMMINGS PARK STE 1800",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016433",
            "telephone_number": "339-227-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6897 W Charleston Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891171640",
            "country_code": "US",
            "telephone_number": "614-783-4936",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "51 Water St # 200",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "MA",
            "postal_code": "02472",
            "country_code": "US",
            "telephone_number": "617-923-7575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADZILOWICZ",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-20",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "2597",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Woburn, MA
• Providers in Woburn, MA by specialty
• Behavior Analyst in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.