Individual provider Active NPI

Chelsea Charda Rolle

  • Behavior Technician
  • Deerfield Beach, FL
National Provider Identifier
1851950539
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
1851950539 Issued in FL
Practice address
500 Fairway Dr Ste 102
Deerfield Beach, FL 33441-1817
Phone
(877) 418-2978
Fax
(866) 500-2186
NPI assigned
Jun 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X FL
Behavior Technician 106S00000X 1851950539 FL Primary

Addresses

Primary practice location

500 Fairway Dr Ste 102
Deerfield Beach, FL 33441-1817

Mailing address

500 Fairway Dr Ste 102
Deerfield BCH, FL 33441-1817
Phone (888) 880-9270

Other practice location 1

501 W Kalmia Dr # K1
Lake Park, FL 33403-2273
Phone (561) 781-1439

Other identifiers 1

IdentifierTypeStateIssuer
1851950539MedicaidFL

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1851950539FLMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1851950539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 FAIRWAY DR STE 102",
            "city": "DEERFIELD BCH",
            "state": "FL",
            "postal_code": "334411817",
            "telephone_number": "888-880-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FAIRWAY DR STE 102",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334411817",
            "telephone_number": "877-418-2978",
            "fax_number": "866-500-2186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 W Kalmia Dr # K1",
            "address_purpose": "LOCATION",
            "city": "Lake Park",
            "state": "FL",
            "postal_code": "334032273",
            "country_code": "US",
            "telephone_number": "561-781-1439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLLE",
        "first_name": "CHELSEA",
        "middle_name": "CHARDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-06",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "1851950539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851950539",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.