Melissa Petersen

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

1309 Oak Way Ave
Glenwood Springs, CO 81601-4049

Phone

(720) 670-9046

Fax

(720) 294-0543

NPI assigned

Aug 3, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Maura Stack Oden LLC

  • Behavior Analyst
  • Englewood, CO
  • NPI 1063016038
  NPD (past)
• Maura Stack Oden LLC

  • Community/Behavioral Health Agency
  • Glenwood Springs, CO
  • NPI 1194186148
  NPD (past)

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1780358796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 OAK WAY AVE",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014049",
            "telephone_number": "720-670-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 OAK WAY AVE",
            "city": "GLENWOOD SPRINGS",
            "state": "CO",
            "postal_code": "816014049",
            "telephone_number": "720-670-9046",
            "fax_number": "720-294-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ben N Peery, M.D.
• Peltzman Chiropractic, PC
• Steven Mitchel Peltzman, D.C.
• Judy Marion Pendas, RCMT
• Tamara L Perry, MSW, LCSW
• Kaylee A Peterson, SWC
• Marjorie A Phelan, PHARMD
• Audrey Elaine Pilkington, MS ED., CCC-SLP
• Maxine Pixley, RN
• Rachel Poirier, BCBA

• Behavior Analyst in Glenwood Springs, CO
• Providers in Glenwood Springs, CO by specialty
• Behavior Analyst in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.