Nicole Diane Overstreet, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

0133001756 Issued in VA

Practice address

118 Cornerstone St
Lynchburg, VA 24502-5346

Phone

(434) 214-8112

NPI assigned

Aug 25, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Blue Ridge ABA LLC

  • Community/Behavioral Health Agency
  • Bedford, VA
  • NPI 1437815065
  NPD Authorized official

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1689287278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 AVEMORE SQUARE PL",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229117228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 CORNERSTONE ST",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245025346",
            "telephone_number": "434-214-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERSTREET",
        "first_name": "NICOLE",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "BCBA, LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133001756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy P. Overby, DMD LTD
• Michael Lee Overfelt, DPM
• Kristina Overholt
• Kelly Overstreet, LPC
• Nancy Overstreet, NP
• Jennifer Leigh Owen, LPC, NCC
• Kelli Latrell Owens, PMHNP-BC
• Evan D. Ownby, MD
• Efim Oykhman
• Rebecca Oylear, SLP

• Behavior Analyst in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Behavior Analyst in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; 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.