Provider Demographics
NPI:1184036097
Name:CHRYSALIS COUNSELING SERVICES PLLC
Entity Type:Organization
Organization Name:CHRYSALIS COUNSELING SERVICES PLLC
Other - Org Name:JULIANA K. TYLER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OWNER/LICENSED MENTAL HEAL
Authorized Official - Prefix:
Authorized Official - First Name:JULIANA
Authorized Official - Middle Name:K
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC, NCC
Authorized Official - Phone:206-604-0996
Mailing Address - Street 1:PO BOX 1604
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-7804
Mailing Address - Country:US
Mailing Address - Phone:206-604-0996
Mailing Address - Fax:
Practice Address - Street 1:144 RAILROAD AVE STE 205C
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-4121
Practice Address - Country:US
Practice Address - Phone:206-604-0996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-27
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 00011082101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty