Active NPI
Blair Wellmon, BCBA
- Behavior Analyst
- Kailua, HI
National Provider Identifier
1437613684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- BACB403898
- Practice address
- Aloha Behavioral Practice
25 Kaneohe Bay Drive
Kailua, HI 96734 - Phone
- (808) 388-1683
- NPI assigned
- Jan 22, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-18-53119 | FL | |
| Behavior Analyst | 103K00000X | BACB403898 | HI | Primary |
Addresses
Primary practice location
Aloha Behavioral Practice
25 Kaneohe Bay Drive
Kailua, HI 96734
Mailing address
2047 Anena St
Kailua, HI 96734-6802
Phone (845) 542-1827
Other practice location 1
7090 Miratech Dr
San Diego, CA 92121-3109
Phone (858) 304-6440
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BACB403898 | Other | HI | BCBA |
| RBT-18-53119 | Other | FL | RBT |
Other names 1
- Blair Caswell
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BACB403898 | HI | MD | Behavioral Analyst |
| RBT-18-53119 | FL | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631491200000",
"number": "1437613684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2047 ANENA ST",
"city": "KAILUA",
"state": "HI",
"postal_code": "967346802",
"telephone_number": "845-542-1827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ALOHA BEHAVIORAL PRACTICE",
"address_2": "25 KANEOHE BAY DRIVE",
"city": "KAILUA",
"state": "HI",
"postal_code": "96734",
"telephone_number": "808-388-1683"
}
],
"practiceLocations": [
{
"address_1": "7090 Miratech Dr",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921213109",
"country_code": "US",
"telephone_number": "858-304-6440",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WELLMON",
"first_name": "BLAIR",
"credential": "BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-22",
"last_updated": "2021-09-13",
"certification_date": "2021-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "FL",
"license": "RBT-18-53119",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "HI",
"license": "BACB403898",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBA",
"identifier": "BACB403898",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RBT",
"identifier": "RBT-18-53119",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "BLAIR",
"last_name": "CASWELL",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Kailua, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.