NPIMap

Individual provider Active NPI

Nicole Perito, LBS, BCBA

  • Behavior Analyst
  • East Stroudsburg, PA
National Provider Identifier
1811539497
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-19-37109
Practice address
175 E Brown St Ste 202
East Stroudsburg, PA 18301-3098
Phone
(570) 234-3989
NPI assigned
Oct 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-19-37109 Primary

Addresses

Primary practice location

175 E Brown St Ste 202
East Stroudsburg, PA 18301-3098

Mailing address

120 E Lake View Dr
Dingmans Ferry, PA 18328-9135
Phone (845) 943-0035

Other names 1

  • Nicole Kovar Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Behavior Solutions, LLC Behavior Analyst PastSince Oct 20, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1811539497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E LAKE VIEW DR",
            "city": "DINGMANS FERRY",
            "state": "PA",
            "postal_code": "183289135",
            "telephone_number": "845-943-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E BROWN ST STE 202",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013098",
            "telephone_number": "570-234-3989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERITO",
        "first_name": "NICOLE",
        "credential": "LBS, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-19-37109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "KOVAR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in East Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.