Provider Demographics
NPI:1629682828
Name:AQUILANTE, NICHOLAS (MSBA, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:AQUILANTE
Suffix:
Gender:M
Credentials:MSBA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2435 NOOSENECK HILL RD UNIT 5
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:RI
Mailing Address - Zip Code:02816-6840
Mailing Address - Country:US
Mailing Address - Phone:401-474-0062
Mailing Address - Fax:401-474-0062
Practice Address - Street 1:2435 NOOSENECK HILL RD UNIT 5
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:RI
Practice Address - Zip Code:02816-6840
Practice Address - Country:US
Practice Address - Phone:401-474-0062
Practice Address - Fax:401-474-0062
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3211-MH-B1103K00000X
103K00000X
RI00355103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst