Provider Demographics
NPI:1003620998
Name:CARMICHAEL, CHEYENNE (RBT)
Entity type:Individual
Prefix:MRS
First Name:CHEYENNE
Middle Name:
Last Name:CARMICHAEL
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:CHEY
Other - Middle Name:
Other - Last Name:LEVESQUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3407 GRAND AVE APT 306
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-4138
Mailing Address - Country:US
Mailing Address - Phone:641-417-9816
Mailing Address - Fax:
Practice Address - Street 1:1860 NW 118TH ST STE 100
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8278
Practice Address - Country:US
Practice Address - Phone:515-402-4130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-03
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IABACB1265438106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician