Nicole Sholly, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-21-165628 Issued in PA

Practice address

780 Newtown Yardley Rd
Newtown, PA 18940-4502

Phone

(215) 704-9224

NPI assigned

Jul 7, 2021

Last updated

Jul 7, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1942871330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 NEWTOWN YARDLEY RD STE 322",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189404502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 NEWTOWN YARDLEY RD",
            "city": "NEWTOWN",
            "state": "PA",
            "postal_code": "189404502",
            "telephone_number": "215-704-9224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOLLY",
        "first_name": "NICOLE",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "PA",
            "license": "RBT-21-165628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "walczak@kwbehavioralconsulting.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "780 Newtown Yardley Rd",
            "city": "Newtown",
            "state": "PA",
            "country_code": "US",
            "postal_code": "189404502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Behavior Technician in Newtown, PA
• Providers in Newtown, PA by specialty
• Behavior Technician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.

Verify at the official NPI Registry.