Provider Demographics
NPI:1831906510
Name:CADLE, NICOLE JOAN (BCBA)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:JOAN
Last Name:CADLE
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 1:1036 CANTINA TER SE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-4790
Mailing Address - Country:US
Mailing Address - Phone:703-314-7865
Mailing Address - Fax:
Practice Address - Street 1:1036 CANTINA TER SE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-4790
Practice Address - Country:US
Practice Address - Phone:703-314-7865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1-24-73401103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst