MEDICARE: CALADIUM BEHAVIOR SOLUTIONS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1821944323
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALADIUM BEHAVIOR SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	2526 SE CALADIUM AVE
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-7213
Country	:	US
Telephone Number	:	302-685-0066
Fax Number	:

Provider Business Practice Location Address
First Line	:	2526 SE CALADIUM AVE
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-7213
Country	:	US
Telephone Number	:	302-685-0066
Fax Number	:

Authorized Official
Title or Position	:	BOARD CERTIFIED BEHAVIOR ANALYST
Name	:	DR. MELISSA L WAMBLE
Credential	:
Telephone Number	:	302-685-0066

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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