Nicole M Vendette, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

11410241 Issued in FL

Practice address

10272 S US Highway 1
Port Saint Lucie, FL 34952-5615

Phone

(407) 947-4675

Fax

(772) 209-6900

NPI assigned

Apr 15, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Nicole Vendette, LLC

  • Community/Behavioral Health Agency
  • Port Saint Lucie, FL
  • NPI 1093298564

  Behavior Analyst

  NPD Authorized official

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

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1679863237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3344 NE SANDRA DR",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349573972",
            "telephone_number": "407-947-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10272 S US HIGHWAY 1",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349525615",
            "telephone_number": "407-947-4675",
            "fax_number": "772-209-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENDETTE",
        "first_name": "NICOLE",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-15",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "11410241",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "11410241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.