Active NPI
Abigail Kathleen Ciccolo
- Behavior Analyst
- Norwell, MA
National Provider Identifier
1811303969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 2237
- Practice address
- 80 Washington St Ste P55
Norwell, MA 02061-1742 - Phone
- (781) 290-3886
- NPI assigned
- Jul 9, 2014
- Last updated
- Aug 17, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 2237 | MA | Primary |
| Developmental Therapist | 222Q00000X | NU |
Addresses
Primary practice location
80 Washington St Ste P55
Norwell, MA 02061-1742
Mailing address
80 Washington St Ste P55
Norwell, MA 02061-1742
Phone (781) 290-3886
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2237 | MA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629158400000",
"number": "1811303969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 WASHINGTON ST STE P55",
"city": "NORWELL",
"state": "MA",
"postal_code": "020611742",
"telephone_number": "781-290-3886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 WASHINGTON ST STE P55",
"city": "NORWELL",
"state": "MA",
"postal_code": "020611742",
"telephone_number": "781-290-3886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CICCOLO",
"first_name": "ABIGAIL",
"middle_name": "KATHLEEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-09",
"last_updated": "2021-08-17",
"certification_date": "2021-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MA",
"license": "2237",
"primary": true
},
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwell, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.