Provider Demographics
NPI:1073103198
Name:NICHOL, JORIE AMBER (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:JORIE
Middle Name:AMBER
Last Name:NICHOL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 W JEFFERSON AVE STE 100A
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80235-2040
Mailing Address - Country:US
Mailing Address - Phone:303-586-7900
Mailing Address - Fax:
Practice Address - Street 1:6900 W JEFFERSON AVE STE 100A
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235-2040
Practice Address - Country:US
Practice Address - Phone:303-586-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-22
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty