Blue Diamond ABA Services LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

BLUE DIAMOND ABA SERVICES LLC

Practice address

102 North Avenue
Mt. Clemens, MI 48043

Phone

(313) 237-3938

NPI assigned

Mar 4, 2020

Last updated

Mar 4, 2020By 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

Mrs. Omotola O. Oluwole, BCBCA

Title

Ceo

Phone

(313) 247-3938

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1699300228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 NORTH AVENUE",
            "city": "MT. CLEMENS",
            "state": "MI",
            "postal_code": "48043",
            "telephone_number": "313-237-3938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 NORTH AVENUE",
            "city": "MT. CLEMENS",
            "state": "MI",
            "postal_code": "48043",
            "telephone_number": "313-237-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE DIAMOND ABA SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "OLUWOLE",
        "authorized_official_first_name": "OMOTOLA",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-247-3938",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BCBCA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Mount Clemens, MI
• Providers in Mount Clemens, MI by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.