Roman Chasteen

Individual provider Active NPI Behavior Technician · Madison, AL

NPI 1104645860 · NPPES record last updated Oct 8, 2024

Key facts

NPI
1104645860
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
24-382281 (AL)
Practice address
100 Spenryn Dr
Madison, AL 35758-1890
Phone
(256) 772-4400
NPI assigned
Oct 8, 2024
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
24-382281ALMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Applied Behavioral Concepts Current
since Oct 13, 2024
Accepting new patients

Locations

100 Spenryn Dr
Madison, AL 35758
Phone (256) 772-4400

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 24-382281 AL Yes

Addresses

Primary practice location

100 Spenryn Dr
Madison, AL 35758-1890

Mailing address

100 Spenryn Dr
Madison, AL 35758-1890

Other providers in Madison, AL

All providers in Madison, AL · Behavior Technician in Alabama

Sources for this page

Verify at the official NPI Registry.