Blue Melo LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

BLUE MELO LLC

Practice address

5900 Balcones Dr Ste 100
Austin, TX 78731-4298

Phone

(469) 712-4036

NPI assigned

Jul 23, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Krisshonda E Odufuwa, M.ED.,BCBA,LBANPI 1720480064

Title

Board Certified Behavior Analyst

Phone

(469) 712-4036

Specialties & licenses 1

Addresses

Other names 1

• Blue Melo LLC Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Krisshonda Elaine Odufuwa, M.E.D, SLPA, BCBA

  • Behavior Analyst
  • McKinney, TX
  • NPI 1720480064
  NPD Authorized official

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

{
    "created_epoch": "1658534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658534400000",
    "number": "1972238830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314298",
            "telephone_number": "469-712-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE MELO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-23",
        "last_updated": "2022-07-23",
        "certification_date": "2022-07-23",
        "status": "A",
        "authorized_official_last_name": "ODUFUWA",
        "authorized_official_first_name": "KRISSHONDA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "BOARD CERTIFIED BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "469-712-4036",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.ED.,BCBA,LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Melo LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Behavior Analyst in Austin, TX
• Providers in Austin, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.