Provider Demographics
NPI:1740789056
Name:ODOM, CHELSEY GABRIELLE (MA,BCBA,LBA)
Entity type:Individual
Prefix:MRS
First Name:CHELSEY
Middle Name:GABRIELLE
Last Name:ODOM
Suffix:
Gender:F
Credentials:MA,BCBA,LBA
Other - Prefix:MS
Other - First Name:CHELSEY
Other - Middle Name:
Other - Last Name:CATING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA,BCBA,LBA
Mailing Address - Street 1:21600 OXNARD ST STE 11800
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-4976
Mailing Address - Country:US
Mailing Address - Phone:818-345-2345
Mailing Address - Fax:
Practice Address - Street 1:2929 MILLERVILLE ROAD
Practice Address - Street 2:SUITE 1-A
Practice Address - City:BATAN ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816
Practice Address - Country:US
Practice Address - Phone:225-963-6006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-02
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAR-1525106S00000X
LAL-551103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician