NICOLE BURGENER (NPI# 1215473632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215473632 |
| Entity Type | Individual |
| Full Name | NICOLE BURGENER |
| Credential | BCBA |
| Practice Address |
515 S 700 E Ste 2a Slc UT 84102 |
| Mailing Address |
515 S 700 E Ste 2a Slc UT 84102-2855 |
| Practice Telephone | 8019354171 |
| Practice Fax Number | 8882616694 |
| Mailing Telephone | 8019354171 |
| Mailing Fax Number | 8882616694 |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2018-10-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | 10903149-2506 | UT | Behavioral Health & Social Service Providers |
| N | 106E00000X | Assistant Behavior Analyst | 109031492507 | UT | Behavioral Health & Social Service Providers |
| N | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| Street Address |
515 S 700 E STE 2A |
| City | SLC |
| State | UT |
| Zip Code | 84102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740894336 | Nicole Demke | Psychologist | 515 S 700 E Ste 2a, Slc, UT 84102-2855 | 2020-09-02 |
| 1619510807 | Michelle K Price | Behavior Technician | 515 S 700 E Ste 2a, Slc, UT 84102-2855 | 2019-10-21 |
| 1720576572 | Brooke L Thurgood | Behavior Technician | 515 S 700 E Ste 2a, Slc, UT 84102-2855 | 2018-04-26 |
| 1740726173 | Jesse Daniels | Behavior Technician | 515 S 700 E Ste 2a, Slc, UT 84102-2855 | 2017-01-09 |
| 1679019004 | Jordan Ossmen | Behavioral Analyst | 515 S 700 E Ste 2a, Slc, UT 84102-2855 | 2017-01-09 |
| 1114463528 | Matthew Wilkins | Behavior Technician | 515 S 700 E Ste 2a, Slc, UT 84102-2855 | 2017-01-09 |
| 1700322211 | Jonas Stotts | Behavioral Analyst | 515 S 700 E Ste 2a, Slc, UT 84102-2855 | 2017-01-09 |
| 1619413028 | Brett Ringger | Behavioral Analyst | 515 S 700 E Ste 2a, Slc, UT 84102-2855 | 2017-01-09 |
| 1689110017 | Tylynn Southwick | Behavior Technician | 515 S 700 E Ste 2a, Slc, UT 84102-2855 | 2017-01-09 |
| 1013453430 | Jenneal Rogers | Behavior Technician | 515 S 700 E Ste 2a, Slc, UT 84102-2855 | 2017-01-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942818604 | Wendy Vazquez | Behavior Technician | 515 S 700 E Suit 2a, Salt Lake City, UT 84102 | 2020-07-20 |
| 1407481245 | Odyssey House Inc | Family Medicine | 743 E 300 S, Salt Lake City, UT 84102 | 2020-03-11 |
| 1093359960 | Hayle Mayer | Behavior Technician | 515 S 700 E Salt Lake City, Suite 2a, Salt Lake, UT 84102 | 2019-11-04 |
| 1326680869 | Ronald Mcdonald House of The Intermountain Area | Meals | 935 E. South Temple, Salt Lake City, UT 84102 | 2019-10-16 |
| 1508419581 | Claire Pemberton | Behavior Technician | 327 E 1300 S, Apt 2, Salt Lake City, UT 84102 | 2019-07-19 |
| 1558923144 | Olivia Anne Hardwick | Social Worker | Transitions At Slrmc, 86 S. 1100 E. Suite 404, Salt Lake City, UT 84102 | 2019-07-03 |
| 1649741802 | Colten Vancampen | Behavior Technician | 515 S 700 E #2a, Salt Lake City, UT 84102 | 2018-12-16 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1104311661 | Malorey Kooyman | Behavior Technician | 515 700 East, Suite 2a, Salt Lake City, UT 84102 | 2018-06-27 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
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| 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 |
|---|---|---|---|---|
| 1750805404 | Kayla Hymas | Behavioral Analyst | 243 E. 400 S., Slc, UT 84111 | 2017-08-02 |
| 1952830457 | Nicholas Barth | Behavioral Analyst | 51 W. 3900 S, Slc, UT 84107 | 2017-06-08 |
| 1679019004 | Jordan Ossmen | Behavioral Analyst | 515 S 700 E Ste 2a, Slc, UT 84102-2855 | 2017-01-09 |
| 1700322211 | Jonas Stotts | Behavioral Analyst | 515 S 700 E Ste 2a, Slc, UT 84102-2855 | 2017-01-09 |
| 1619413028 | Brett Ringger | Behavioral Analyst | 515 S 700 E Ste 2a, Slc, UT 84102-2855 | 2017-01-09 |
| 1679019186 | Kaylie Stephens | Behavioral Analyst | 515 S 700 E Ste 2a, Slc, UT 84102-2855 | 2017-01-09 |
| 1548706955 | Caitlin Ossmen | Behavioral Analyst | 515 S 700 E Ste 2a, Slc, UT 84102-2855 | 2017-01-09 |
| 1023551405 | Nicholas Klinkefus | Behavioral Analyst | 515 S 700 E Ste 2a, Slc, UT 84102 | 2016-12-02 |
| 1508309980 | Alisa Harman | Behavioral Analyst | 515 S 700 E Ste 2a, Slc, UT 84102-2855 | 2016-12-02 |
| 1295278679 | Amanda Taylor | Behavioral Analyst | 515 S 700 E, Slc, UT 84102-2801 | 2016-12-02 |
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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.