Provider Demographics
NPI:1154032324
Name:O'CONNELL, NICOLE (MS, BCBA LABA)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:MS, BCBA LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOXFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01921-1126
Mailing Address - Country:US
Mailing Address - Phone:978-382-0397
Mailing Address - Fax:
Practice Address - Street 1:100 CUMMINGS CTR STE 135C
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6263
Practice Address - Country:US
Practice Address - Phone:978-743-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst