Provider Demographics
NPI:1235972290
Name:NIGRELLI, LISA LUCILLE (BCBA)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:LUCILLE
Last Name:NIGRELLI
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5249 QUITMAN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-4033
Mailing Address - Country:US
Mailing Address - Phone:303-847-3331
Mailing Address - Fax:
Practice Address - Street 1:6385 CORPORATE DR STE 200-41
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-5901
Practice Address - Country:US
Practice Address - Phone:877-881-3090
Practice Address - Fax:520-783-0057
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-24-73368103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst