Provider Demographics
NPI:1619518651
Name:BILLIRI, NIKKI (MS, BCBA, LABA)
Entity Type:Individual
Prefix:
First Name:NIKKI
Middle Name:
Last Name:BILLIRI
Suffix:
Gender:F
Credentials:MS, BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 MISHAWUM RD
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-2431
Mailing Address - Country:US
Mailing Address - Phone:781-405-0111
Mailing Address - Fax:781-528-0423
Practice Address - Street 1:182 MISHAWUM RD
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-2431
Practice Address - Country:US
Practice Address - Phone:781-405-0111
Practice Address - Fax:781-528-0423
Is Sole Proprietor?:No
Enumeration Date:2019-10-01
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
MA3039103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1303287OtherMBHP
MAM18633OtherBCBS
MA0000023532OtherBMC
MA99618201OtherNETWORK HEALTH
MA042611055OtherTAX ID
MA1004745OtherFALLON
MA1004745OtherNHP