NICOLE A FAIRBURN (NPI# 1427698869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427698869 |
| Entity Type | Individual |
| Full Name | NICOLE A FAIRBURN |
| Practice Address |
2600 Fernbrook Ln N Ste 138 Plymouth MN 55447-4752 |
| Practice Telephone | 9525440349 |
| Mailing Telephone | 9525440349 |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2020-01-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924959 | Nicole E Fairburn | Social Worker | 601 South Edwin C Moses Blvd, Dayton, OH 45417-3424 | 2019-07-17 |
| Street Address |
2600 FERNBROOK LN N STE 138 |
| City | PLYMOUTH |
| State | MN |
| Zip Code | 55447-4752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649469289 | Autism Matters, Inc. | Speech-Language Pathologist | 2600 Fernbrook Ln N Ste 138, Plymouth, MN 55447-4752 | 2007-10-19 |
| 1235736539 | Martholine Nyonue | Behavior Technician | 2600 Fernbrook Ln N Ste 138, Plymouth, MN 55447-4752 | 2020-10-08 |
| 1013521731 | Asavari Tembe | Behavior Technician | 2600 Fernbrook Ln N Ste 138, Plymouth, MN 55447-4752 | 2020-08-31 |
| 1407473952 | Alicia Marie Latraille | Behavior Technician | 2600 Fernbrook Ln N Ste 138, Plymouth, MN 55447-4752 | 2020-07-01 |
| 1598387441 | Kelly Jean Larsgard | Behavioral Analyst | 2600 Fernbrook Ln N Ste 138, Plymouth, MN 55447-4752 | 2020-05-14 |
| 1346860582 | Varfee Guworgo Acquoi | Behavior Technician | 2600 Fernbrook Ln N Ste 138, Plymouth, MN 55447-4752 | 2020-04-17 |
| 1609402247 | Jareal Lee Zollicoffer | Behavior Technician | 2600 Fernbrook Ln N Ste 138, Plymouth, MN 55447-4752 | 2020-03-16 |
| 1003442500 | Kristyne Bazinet | Speech-Language Pathologist | 2600 Fernbrook Ln N Ste 138, Plymouth, MN 55447-4752 | 2020-03-16 |
| 1861028599 | Eboni White | Behavior Technician | 2600 Fernbrook Ln N Ste 138, Plymouth, MN 55447-4752 | 2020-03-13 |
| 1437782307 | Makenna Rose Kaehler | Behavior Technician | 2600 Fernbrook Ln N Ste 138, Plymouth, MN 55447-4752 | 2020-02-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952916165 | Benjamin Thomas Garbow | Nurse Anesthetist, Certified Registered | 14700 28th Avenue North, Plymouth, MN 55447 | 2020-09-14 |
| 1588146914 | Alicia Mae Donahue | Social Worker | 15805 26th Ave N Unit D, Plymouth, MN 55447 | 2018-09-01 |
| 1497262224 | Rajo Care Home Inc | Assisted Living Facility | 14015 Rockford Rd, Plymouth, MN 55447 | 2018-01-02 |
| 1790145647 | Mary Kathleen Salveson | Occupational Therapist | Therapy Junction 14130 23rd Ave N, Plymouth, MN 55447 | 2016-03-03 |
| 1477954253 | Very Best PCa Services | Home Health | 14300 34th Ave N, #111, Plymouth, MN 55447 | 2014-09-11 |
| 1194133157 | Adam Schmitt | Dermatology | 2 Carlson Pkwy N Ste 240, Plymouth, MN 55447 | 2014-07-22 |
| 1336480946 | Arthur Andrew Hoffman | Chiropractor | 16815 22nd Ave North, Plymouth, MN 55447 | 2013-03-06 |
| 1598001067 | North Memorial Health Care | Clinic/Center | 15535 34th Avenue N., Plymouth, MN 55447 | 2013-01-02 |
| 1396097069 | Kristin Lynn Spencer | Nurse Practitioner | 3007 Harbor Lane North, Park Nicollet Clinic Plymouth - Family Medicine, Plymouth, MN 55447 | 2012-10-05 |
| 1689930554 | Linda Gail Olson | General Practice | 17935 24th Ave N, Minneapolis, MN 55447 | 2012-04-05 |
| Find all providers in zip 55447 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609480102 | Kelly Romano | Behavior Technician | 15 Dickson Dr, Plymouth, MA 02360-6832 | 2020-09-02 |
| 1740808484 | Dennis Fox | Behavior Technician | 19 Jamies Path, Plymouth, MA 02360-4980 | 2020-07-09 |
| 1700435856 | Leeann Winner | Behavior Technician | 650 Church St Ste 216, Plymouth, MI 48170-1689 | 2019-09-10 |
| 1730654682 | Leah Liakos | Behavior Technician | 650 Church St # 215, Plymouth, MI 48170-1689 | 2018-10-08 |
| 1659846517 | Reed Holden | Behavior Technician | 650 Church St Unit 215, Plymouth, MI 48170-1689 | 2018-10-08 |
| 1659860567 | Taishawn Miller | Behavior Technician | 13225 58th Ave N Apt E, Plymouth, MN 55442-1685 | 2018-05-07 |
| 1730608597 | Cristin M Ramage | Behavior Technician | 44 Industrial Park Rd, Plymouth, MA 02360-4829 | 2017-09-13 |
| 1164949160 | Qiana Eberly | Behavior Technician | 650 Church St Ste 215, Plymouth, MI 48170-1689 | 2017-08-29 |
| 1093316937 | Cailin Murphy | Behavior Technician | 44670 Ann Arbor Rd W, Plymouth, MI 48170-3962 | 2020-11-06 |
| 1891396602 | Allison Munguia | Behavior Technician | 44670 Ann Arbor Rd W, Plymouth, MI 48170-3962 | 2020-11-06 |
| Find all providers in PLYMOUTH | ||||
Please comment or provide details below to improve the information on NICOLE A FAIRBURN.
| 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.