Nicole Rae McDonald, BCBA, LBA
Individual provider Active NPI Behavior Analyst · Jackson, MO
NPI 1326625823 · NPPES record last updated May 18, 2021
Key facts
- NPI
- 1326625823
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1-21-48606 (MO)
- Practice address
- 436 Tumbleweed Pass
Jackson, MO 63755-8541 - Phone
- (417) 894-1231
- NPI assigned
- Mar 29, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Positive Change ABA LLC | Behavior Analyst | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst |
103K00000X | 1-21-48606 | MO | Yes |
Addresses
Primary practice location
436 Tumbleweed Pass
Jackson, MO 63755-8541
Mailing address
436 Tumbleweed Pass
Jackson, MO 63755-8541
Phone (417) 894-1231
Other names
- Positie Change ABA LLC
Other providers in Jackson, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.