Healthcare Provider Details

I. General information

NPI: 1003744764
Provider Name (Legal Business Name): CHELSEA K LANGLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 OAKLEAF PLANTATION PKWY STE 101
ORANGE PARK FL
32065-3626
US

IV. Provider business mailing address

3230 CALLIE LN
GREEN COVE SPRINGS FL
32043-9591
US

V. Phone/Fax

Practice location:
  • Phone: 904-945-6205
  • Fax: 888-498-7244
Mailing address:
  • Phone: 904-945-6205
  • Fax: 888-498-7244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-536494
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: