Provider Demographics
NPI:1417307299
Name:ROY, CHELSEA MELANIE (MA,BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:MELANIE
Last Name:ROY
Suffix:
Gender:F
Credentials:MA,BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 269
Mailing Address - Street 2:
Mailing Address - City:ORLEANS
Mailing Address - State:VT
Mailing Address - Zip Code:05860-0269
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:212 PROUTY DR STE 2
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-9455
Practice Address - Country:US
Practice Address - Phone:802-557-0941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-13
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT146-0134124103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst