Active NPI
Laura Nicoll Vicioso
- Behavior Technician
- Philadelphia, PA
National Provider Identifier
1649951534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 110 Church St
Philadelphia, PA 19106-2201 - Phone
- (267) 807-0550
- NPI assigned
- Jul 25, 2023
- 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 Technician | 106S00000X | Primary |
Addresses
Primary practice location
110 Church St
Philadelphia, PA 19106-2201
Mailing address
5244 N 6TH St
Philadelphia, PA 19120-3119
Phone (267) 778-7144
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elevated Kids | Behavior Technician | Current | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690243200000",
"number": "1649951534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5244 N 6TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191203119",
"telephone_number": "267-778-7144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 CHURCH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191062201",
"telephone_number": "267-807-0550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICIOSO",
"first_name": "LAURA",
"middle_name": "NICOLL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-25",
"last_updated": "2023-07-25",
"certification_date": "2023-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.