Nicole Deer

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-20-144922 Issued in CT

Practice address

4 Broadway Avenue Ext Ste 3
Mystic, CT 06355-2875

Phone

(860) 980-3233

NPI assigned

May 17, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1659945491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BROADWAY AVENUE EXT STE 3",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063552875",
            "telephone_number": "860-980-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 BROADWAY AVENUE EXT STE 3",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063552875",
            "telephone_number": "860-980-3233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "336 Halls Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Colchester",
            "state": "CT",
            "postal_code": "064151452",
            "country_code": "US",
            "telephone_number": "860-980-3233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEER",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CT",
            "license": "RBT-20-144922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1659826048",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Mystic, CT
• Behavior Technician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.