Provider Demographics
NPI:1649649286
Name:ORLAND, NICHOLAS VINCENT (BCBA)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:VINCENT
Last Name:ORLAND
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:PO BOX 47124
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32247-7124
Mailing Address - Country:US
Mailing Address - Phone:413-523-3468
Mailing Address - Fax:
Practice Address - Street 1:7362 REMCON CIR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1623
Practice Address - Country:US
Practice Address - Phone:866-273-2451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-24
Last Update Date:2023-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-14-9572103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst