Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nicole Ashley Petillo, BCBA, LBA

Individual provider Behavior Technician · NPI 1366271843

Nicole Ashley Petillo, BCBA, LBA is a Behavior Technician in Coram, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2024
Specialties on file
2
What do these letters mean?
BCBA — Board Certified Behavior Analyst
Designs and supervises applied behaviour analysis programmes, often for autism.

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Practice location Address checks out

5 Fillmore Ct
Coram, NY 11727-3910
Phone: (718) 844-1406
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X · Licence 004157 (NY)
Behavior Technician Taxonomy 106S00000X (NY)

Record details

NPI number1366271843
Entity typeIndividual (Type 1)
GenderFemale
Credentials BCBA , LBA
Sole proprietorYes
NPI enumeratedJuly 31, 2024
Last updated in NPPESMarch 18, 2025
Certification dateMarch 18, 2025

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