Provider Demographics
NPI:1649667031
Name:MCCAWLEY, CHELSEA LANE (MSC, BCBA)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:LANE
Last Name:MCCAWLEY
Suffix:
Gender:F
Credentials:MSC, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3685 KEARNY VILLA RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1950
Mailing Address - Country:US
Mailing Address - Phone:858-966-8555
Mailing Address - Fax:858-966-8599
Practice Address - Street 1:3685 KEARNY VILLA RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1950
Practice Address - Country:US
Practice Address - Phone:858-966-8555
Practice Address - Fax:858-966-8599
Is Sole Proprietor?:No
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-14-17489103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst