Healthcare Provider Details

I. General information

NPI: 1518465376
Provider Name (Legal Business Name): NICOLE SILVERMAN BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE BISHOP BCBA

II. Dates (important events)

Enumeration Date: 01/26/2018
Last Update Date: 12/01/2022
Certification Date: 12/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7220 W JEFFERSON AVE STE 202
LAKEWOOD CO
80235-2023
US

IV. Provider business mailing address

6220 PRAIRIE HILLS VW APT 206
COLORADO SPRINGS CO
80923-3541
US

V. Phone/Fax

Practice location:
  • Phone: 303-225-7673
  • Fax: 866-283-0595
Mailing address:
  • Phone: 816-550-8948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-45184
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: