Sarah Marie Nickerson

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-19-38049 Issued in MA

Practice address

560 Sylvan Ave
Englewood Cliffs, NJ 07632-3119

Phone

(646) 873-6660

Fax

(646) 859-4440

NPI assigned

Nov 21, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Sarah Marie Costello Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1699289199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 SYLVAN AVE",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076323119",
            "telephone_number": "207-614-2313",
            "fax_number": "646-859-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 SYLVAN AVE",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076323119",
            "telephone_number": "646-873-6660",
            "fax_number": "646-859-4440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 Oak St",
            "address_purpose": "LOCATION",
            "city": "Newton",
            "state": "MA",
            "postal_code": "024641492",
            "country_code": "US",
            "telephone_number": "617-658-5611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "SARAH",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-21",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MA",
            "license": "1-19-38049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "COSTELLO",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Behavior Analyst in Englewood Cliffs, NJ
• Providers in Englewood Cliffs, NJ by specialty
• Behavior Analyst in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.