Healthcare Provider Details

I. General information

NPI: 1790506756
Provider Name (Legal Business Name): ELIZABETH CHELSEY MADISON MA, RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH BURTON

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

971 N GILBERT RD STE 101
GILBERT AZ
85234-3481
US

IV. Provider business mailing address

4115 E COVINA ST
MESA AZ
85205-9323
US

V. Phone/Fax

Practice location:
  • Phone: 480-559-8089
  • Fax: 317-520-8200
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-447685
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: