MEDICARE: CHELSEA J CORDERO RBT

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	106S00000X	Behavior Technician		IN
2	103K00000X	Behavior Analyst		IN

General Provider Information

NPI Number	:	1912494725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA J CORDERO RBT

Provider Business Mailing Address
First Line	:	3595 SAGAMORE PKWY N STE 5
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47904-1095
Country	:	US
Telephone Number	:	317-249-2242
Fax Number	:

Provider Business Practice Location Address
First Line	:	3595 SAGAMORE PKWY N # 5
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47904-1095
Country	:	US
Telephone Number	:	765-269-7756
Fax Number	:	317-663-1175

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

Provider Enumeration Date	:	04/17/2018
Last Update Date	:	11/04/2025

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Directions to “ CHELSEA J CORDERO RBT” Practice Location

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