Melody Ericson

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BA-430 Issued in HI

Practice address

203 Kapaa Quarry PL #5002
Kailua, HI 96734

Phone

(808) 247-2973

NPI assigned

Sep 20, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Melody Mansour Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1255840393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99-870 IWAENA ST # 101",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967013278",
            "telephone_number": "808-277-7736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 KAPAA QUARRY PL #5002",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "96734",
            "telephone_number": "808-247-2973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "99-870 Iwaena St # 101",
            "address_purpose": "LOCATION",
            "city": "Aiea",
            "state": "HI",
            "postal_code": "967013278",
            "country_code": "US",
            "telephone_number": "808-277-7736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERICSON",
        "first_name": "MELODY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-20",
        "last_updated": "2022-07-21",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "HI",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "HI",
            "license": "BA-430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELODY",
            "last_name": "MANSOUR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Etsuko Foster LCSW LLC

• Behavior Analyst in Kailua, HI
• Providers in Kailua, HI by specialty
• Behavior Analyst in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.