NICOLE MARIE WILLIS (NPI# 1235519307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235519307 |
| Entity Type | Individual |
| Full Name | NICOLE MARIE WILLIS |
| Practice Address |
538 Broadhollow Rd Ste 202 Melville NY 11747-3668 |
| Mailing Address |
9 Bear Street Selden NY 11784 |
| Practice Telephone | 6313857780 |
| Mailing Telephone | 6314282952 |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2015-06-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992354039 | Nicole Willis | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2019-09-11 |
| 1881066736 | Nicole Willis | Social Worker | 4500 S Lancaster Rd, Dallas, TX 75216-7167 | 2015-10-30 |
| 1831428143 | Nicole Willis | Pediatrics | 15951 Little Axe Drive, Norman, OK 73026 | 2009-12-15 |
| 1093992539 | Nicole Willis | Chiropractor | 1570 E Heritage Park St, Ste 175, Meridian, ID 83646-6445 | 2008-01-28 |
| 1235331232 | Nicole Rae Willis | Occupational Therapist | 4500 S Washington St - Altru Specialty Center, Grand Forks, ND 58201 | 2007-06-01 |
| Street Address |
538 BROADHOLLOW RD STE 202 |
| City | MELVILLE |
| State | NY |
| Zip Code | 11747-3668 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457610826 | Heather M Bolanos | Speech-Language Pathologist | 538 Broadhollow Rd Ste 202, Melville, NY 11747-3668 | 2012-05-04 |
| 1699289736 | Eileen Beth Liebler | Specialist | 538 Broadhollow Rd Ste 202, Melville, NY 11747-3668 | 2017-11-28 |
| 1316458532 | Karen Ruth Magee | Behavior Technician | 538 Broadhollow Rd Ste 202, Melville, NY 11747-3668 | 2017-10-15 |
| 1124538921 | Jenetta Butler | Behavior Technician | 538 Broadhollow Rd Ste 202, Melville, NY 11747-3668 | 2017-10-05 |
| 1790202125 | Rebecca-lynne Cipriano | Early Intervention Provider Agency | 538 Broadhollow Rd Ste 202, Melville, NY 11747-3668 | 2017-08-25 |
| 1154841443 | Christian Bustamante | Specialist | 538 Broadhollow Rd Ste 202, Melville, NY 11747-3668 | 2017-06-27 |
| 1477073849 | Christine Burns | Behavior Technician | 538 Broadhollow Rd Ste 202, Melville, NY 11747-3668 | 2017-06-26 |
| 1043748650 | Natalie L Lindo | Specialist | 538 Broadhollow Rd Ste 202, Melville, NY 11747-3668 | 2017-05-25 |
| 1568999449 | Jenna Caruso | Behavior Technician | 538 Broadhollow Rd Ste 202, Melville, NY 11747-3668 | 2017-05-22 |
| 1730616335 | Christopher Michael Cardella | Specialist | 538 Broadhollow Rd Ste 202, Melville, NY 11747-3668 | 2017-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891316139 | Shaina Flanzraich | Physical Therapist | 3237 1800 Walt Whitman Rd, 120, Melville, NY 11747 | 2020-04-28 |
| 1952943763 | Liana Danielle Maher | Behavior Technician | 225 Broadhallow Road Suite 402, Melville, NY 11747 | 2019-10-14 |
| 1114402096 | Anicka Inez Douglas | Behavior Technician | 225 Broadhollow Road Suite 402, Melville, NY 11747 | 2018-09-26 |
| 1962988717 | Brien Nina-louise Potter | Behavior Technician | 225 Broadhollow Road, Suite 402, Melville, NY 11747 | 2018-07-16 |
| 1750804951 | Iri: Innovative Resources for Independence | Intermediate Care Facility, Mentally Retarded | 922 Rainbow Commons Ct, Melville, NY 11747 | 2017-07-19 |
| 1386178127 | Marissa Zydor | Specialist | 538 Ny-110 #202, Melville, NY 11747 | 2017-04-19 |
| 1992236624 | Annmarie Irene Russo | Behavior Technician | 538 Ny-110, Suite 202, Melville, NY 11747 | 2017-03-24 |
| 1205378130 | Independent Group Home Living Program, Inc | Nursing Facility/Intermediate Care Facility | 914 Rainbow Commons, Melville, NY 11747 | 2016-11-09 |
| 1932641867 | Independent Group Home Living Program, Inc | Nursing Facility/Intermediate Care Facility | 917 Rainbow Commons, Melville, NY 11747 | 2016-11-09 |
| 1740732999 | Independent Group Home Living Program, Inc | Nursing Facility/Intermediate Care Facility | 924 Rainbow Commons, Melville, NY 11747 | 2016-11-03 |
| Find all providers in zip 11747 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235793274 | Erika Flerx | Specialist | 9 Woodmont Rd, Melville, NY 11747-3312 | 2019-04-25 |
| 1780166637 | Arielle Hudesman | Specialist | 21 Villas Cir, Melville, NY 11747-3051 | 2018-09-06 |
| 1992297394 | Alisa Ruth Ellis | Specialist | 2320 Court North Dr, Melville, NY 11747-8147 | 2018-05-31 |
| 1578083192 | Sharon Albert | Specialist | 5 Pembury Ct, Melville, NY 11747-3331 | 2017-06-24 |
| 1992231435 | Carissa Lynn Agnello | Specialist | 583 Broadhollow Rd, Suite 202, Melville, NY 11747-5017 | 2017-05-03 |
| 1386178127 | Marissa Zydor | Specialist | 538 Ny-110 #202, Melville, NY 11747 | 2017-04-19 |
| 1619401452 | Erika Hawthorne | Specialist | 538 Broadhollow Road West Suite 202, Melville, NY 11757 | 2017-04-19 |
| 1659823201 | Evelyn Guillermo | Specialist | 15 Seton St, Melville, NY 11747-1329 | 2016-10-31 |
| 1730637026 | Kristen Allen | Specialist | 18 Rainer St, Melville, NY 11747-1725 | 2016-09-14 |
| 1245786862 | Maria Vanegas | Specialist | 538 Broadhollow Rd Suite 202, Melville, NY 11747 | 2016-09-01 |
| Find all providers in MELVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.