NICHOLE CLARK (NPI# 1962923995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962923995 |
| Entity Type | Individual |
| Full Name | NICHOLE CLARK |
| Credential | BCBA |
| Practice Address |
13300 Hickman Rd Ste 110 Clive IA 50325-8616 |
| Mailing Address |
3418 Kingman Blvd Apt 2 Des Moines IA 50311-3718 |
| Practice Telephone | 5159878835 |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2017-07-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548464936 | Nichole Deann Clark | Nurse Practitioner | 145 Shakerag Road, Clinton, AR 72031-6657 | 2007-06-12 |
| 1093377905 | Nichole N Clark | Nurse Practitioner | 3200 E Racine St, Janesville, WI 53546-2343 | 2019-07-01 |
| Street Address |
13300 HICKMAN RD STE 110 |
| City | CLIVE |
| State | IA |
| Zip Code | 50325-8616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811337389 | Metro West Learning Center, LLC | Counselor | 13300 Hickman Rd Ste 110, Clive, IA 50325 | 2013-06-28 |
| 1730708363 | Zola Flores Schultz | Behavioral Analyst | 13300 Hickman Rd Ste 110, Clive, IA 50325-8616 | 2020-04-14 |
| 1346892395 | Taylor Rae Crane | Occupational Therapist | 13300 Hickman Rd Ste 110, Clive, IA 50325-8616 | 2019-07-10 |
| 1548823974 | Jeri Marlene Fyock | Speech-Language Pathologist | 13300 Hickman Rd Ste 110, Clive, IA 50325-8616 | 2019-04-22 |
| 1225543150 | Nehemiah Sahr Koroma | Behavior Technician | 13300 Hickman Rd Ste 110, Clive, IA 50325-8616 | 2017-12-14 |
| 1518472430 | Julie Anne Dauterive | Behavioral Analyst | 13300 Hickman Rd Ste 110, Clive, IA 50325-8616 | 2017-12-14 |
| 1396192233 | Jeanine Stanley | Speech-Language Pathologist | 13300 Hickman Rd Ste 110, Clive, IA 50325-8616 | 2016-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104449446 | Clive Behavioral Health LLC | Psychiatric Hospital | 1500 Nw 114th St, Clive, IA 50325 | 2020-05-21 |
| 1609426519 | Caroline Silva Pereira Lara Ribeiro | Occupational Therapist | 15500 Boston Parkway, Appt 110, Clive, IA 50325 | 2019-09-13 |
| 1487203873 | Karen Turnure | Technician | 4524 Nw 16th St, Clive, IA 50325 | 2019-09-09 |
| 1659920320 | Phs Walnut Ridge LLC | Skilled Nursing Facility | 1703 Campus Drive, Clive, IA 50325 | 2019-09-05 |
| 1700288834 | Lindsey White | Chiropractor | 12931 University Ave, Suite 103, Clive, IA 50325 | 2014-09-19 |
| 1700110343 | Rodolfo Mallorca Legislador Sr. | Family Medicine | 1665 Nw 97th St., Clive, IA 50325 | 2009-09-30 |
| 1891961900 | Erin Ducharme | Dermatology | 16349 Sheridan Drive, Suite 101, Clive, IA 50325 | 2008-05-08 |
| 1174792873 | The Iowa Clinic PC | Prosthetic/Orthotic Supplier | 12655 University Ave, Ste 160, Clive, IA 50325 | 2008-02-27 |
| 1164623393 | Melisa Coaker | Internal Medicine | 1275 Nw 128th St, Ste 200, Clive, IA 50325 | 2007-05-28 |
| 1558582536 | Sheila D. Keene | Counselor | 1350 Nothwest 138th Strreet, Suite 200, Des Moines, IA 50325 | 2007-05-01 |
| Find all providers in zip 50325 | ||||
| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861997389 | Ryhanna Elizabeth Singleton | Behavioral Analyst | 9902 Swanson Blvd, Clive, IA 50325-6932 | 2018-03-27 |
| 1851716450 | Leah Horner | Behavioral Analyst | 1860 Nw 118th St Ste 100, Clive, IA 50325-8278 | 2014-02-19 |
| 1689275869 | Stacee Leatherman | Behavioral Analyst | 9902 Swanson Blvd, Clive, IA 50325-6932 | 2020-11-04 |
| 1659998771 | Andrew John Foster-willer | Behavioral Analyst | 1860 Nw 118th St Ste 100, Clive, IA 50325-8278 | 2020-07-06 |
| 1730708363 | Zola Flores Schultz | Behavioral Analyst | 13300 Hickman Rd Ste 110, Clive, IA 50325-8616 | 2020-04-14 |
| 1487292561 | Kiley Elizabeth Dewhurst | Behavioral Analyst | 1860 Nw 118th St Ste 100, Clive, IA 50325-8278 | 2019-12-19 |
| 1588215719 | Brandon Reece Arkland | Behavioral Analyst | 1860 Nw 118th St Ste 100, Clive, IA 50325-8278 | 2019-09-29 |
| 1306491402 | Caitlin Zoe Kotz | Behavioral Analyst | 1860 Nw 118th St Ste 100, Clive, IA 50325-8278 | 2019-08-06 |
| 1457826802 | Josie Marie Hupp | Behavioral Analyst | 1860 Nw 118th St, Clive, IA 50325-8278 | 2018-10-11 |
| 1881180420 | Natisha Lee Frush | Behavioral Analyst | 1860 Nw 118th St Ste 100, Clive, IA 50325-8278 | 2018-07-06 |
| Find all providers in CLIVE | ||||
Please comment or provide details below to improve the information on NICHOLE CLARK.
| 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.