Blue Balloon NC LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

BLUE BALLOON NC LLC

Doing business as

Blue Balloon ABA

Practice address

8601 Six Forks Road, Suite 400, Office 444
Raleigh, NC 27615-5276

Phone

(551) 302-0306

NPI assigned

Jan 11, 2022

Last updated

May 11, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Sussman

Title

Member

Phone

(201) 216-9500

Specialties & licenses 5

Addresses

Other names 1

• Blue Balloon ABA Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1235880329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 BELGROVE DR",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070321507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 SIX FORKS ROAD, SUITE 400, OFFICE 444",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276155276",
            "telephone_number": "551-302-0306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Belgrove Dr",
            "address_purpose": "LOCATION",
            "city": "Kearny",
            "state": "NJ",
            "postal_code": "070321507",
            "country_code": "US",
            "telephone_number": "201-216-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLUE BALLOON NC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-11",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A",
        "authorized_official_last_name": "SUSSMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "201-216-9500"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Balloon ABA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alicia Blount, NP
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• Kelly Blount, PA-C
• Tonya Blowe
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• Blue Jay ABA NC LLC
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• Behavior Analyst in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Behavior Analyst in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.