Healthcare Provider Details

I. General information

NPI: 1114542339
Provider Name (Legal Business Name): NICHOLAS WHITE-ONEAL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2020
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 E FRANKLIN ST
HAGERSTOWN MD
21740-4914
US

IV. Provider business mailing address

8865 NORWIN AVE STE 27
NORTH HUNTINGDON PA
15642-2769
US

V. Phone/Fax

Practice location:
  • Phone: 866-287-2306
  • Fax:
Mailing address:
  • Phone: 866-287-2036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: