Provider Demographics
NPI:1578128013
Name:GENTILE, CHELSEA M (BCBA)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:M
Last Name:GENTILE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LUNENBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01462-1428
Mailing Address - Country:US
Mailing Address - Phone:978-424-5031
Mailing Address - Fax:
Practice Address - Street 1:39 MAIN ST
Practice Address - Street 2:
Practice Address - City:LUNENBURG
Practice Address - State:MA
Practice Address - Zip Code:01462-1428
Practice Address - Country:US
Practice Address - Phone:978-424-5031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-09
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst