Healthcare Provider Details

I. General information

NPI: 1750753505
Provider Name (Legal Business Name): CHELSEA ANNE GAUDREAU M.A., BCBA, LABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 FRONT ST STE 102
WEST SPRINGFIELD MA
01089-3100
US

IV. Provider business mailing address

150 FRONT ST STE 102
WEST SPRINGFIELD MA
01089-3100
US

V. Phone/Fax

Practice location:
  • Phone: 413-657-1917
  • Fax: 413-301-8205
Mailing address:
  • Phone: 413-657-1917
  • Fax: 413-301-8205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number662
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number828
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: