Chelsea Angle

Individual provider Active NPI Behavior Technician · O Fallon, IL

NPI 1316583305 · NPPES record last updated Nov 25, 2019

Key facts

NPI
1316583305
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
6 Eagle Ctr Ste 1
O Fallon, IL 62269-1945
Phone
(618) 206-8816
NPI assigned
Nov 25, 2019
Sex
Female
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

Practice roles

OrganizationSpecialtyStatusNew patients
Acorn Health of Illinois, LLC Current
since Dec 9, 2019
Accepting new patients

Locations

6 Eagle Ctr
Ste 1
O Fallon, IL 62269
Phone (618) 206-8816

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

6 Eagle Ctr Ste 1
O Fallon, IL 62269-1945

Mailing address

6 Eagle Ctr Ste 1
O Fallon, IL 62269-1945

Other providers in O Fallon, IL

All providers in O Fallon, IL · Behavior Technician in Illinois

Sources for this page

Verify at the official NPI Registry.