Provider Demographics
NPI:1164809422
Name:HOUCK, NICOLAS ALAN (BCBA)
Entity Type:Individual
Prefix:
First Name:NICOLAS
Middle Name:ALAN
Last Name:HOUCK
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 MURFREESBORO PIKE STE 702
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2679
Mailing Address - Country:US
Mailing Address - Phone:615-361-4000
Mailing Address - Fax:615-815-1946
Practice Address - Street 1:1081 THORNBERRY DR
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-1672
Practice Address - Country:US
Practice Address - Phone:270-854-1480
Practice Address - Fax:615-815-1946
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-15-6481103K00000X
KY240843103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-16-21378OtherBCBA CERTIFICATION