Active NPI
Nicole Sjostrom
- Behavior Analyst
- West Chester, PA
National Provider Identifier
1619542545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BH005295
- Practice address
- 419 N Franklin St Ste 2
West Chester, PA 19380-2400 - Phone
- (267) 243-5970
- NPI assigned
- May 24, 2021
- 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 | BH005295 | PA | Primary |
Addresses
Primary practice location
419 N Franklin St Ste 2
West Chester, PA 19380-2400
Mailing address
419 N Franklin St Ste 2
West Chester, PA 19380-2400
Phone (267) 243-5970
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124667456 | Medicaid | PA |
Other names 1
- Nicole Doyle
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 |
|---|---|---|---|
| BH005295 | PA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700611200000",
"number": "1619542545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "419 N FRANKLIN ST STE 2",
"city": "WEST CHESTER",
"state": "PA",
"postal_code": "193802400",
"telephone_number": "267-243-5970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "419 N FRANKLIN ST STE 2",
"city": "WEST CHESTER",
"state": "PA",
"postal_code": "193802400",
"telephone_number": "267-243-5970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SJOSTROM",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-24",
"last_updated": "2023-11-22",
"certification_date": "2023-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "PA",
"license": "BH005295",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1124667456",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "NICOLE",
"last_name": "DOYLE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in West Chester, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.