Provider Demographics
NPI:1790671733
Name:LINDGREN, NICHOLAS (PHD, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:LINDGREN
Suffix:
Gender:M
Credentials:PHD, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4344 OVERTON LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-1318
Mailing Address - Country:US
Mailing Address - Phone:805-433-5571
Mailing Address - Fax:
Practice Address - Street 1:6345 BALBOA BLVD STE 163
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-5236
Practice Address - Country:US
Practice Address - Phone:805-433-5571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst