MEDICARE: CHELSEA MARIE WAITE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1417335316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA MARIE WAITE

Provider Business Mailing Address
First Line	:	800 CHESTNUT ST # 57
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37402-2510
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 N KINGS HWY STE AANDB
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-3946
Country	:	US
Telephone Number	:	866-598-4571
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2015
Last Update Date	:	12/11/2025

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Directions to “ CHELSEA MARIE WAITE ” Practice Location

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