Provider Demographics
NPI:1346491511
Name:CHRYSALIS COUNSELING, LLC
Entity Type:Organization
Organization Name:CHRYSALIS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MOWREY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:206-473-2700
Mailing Address - Street 1:PO BOX 46565
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98146-0565
Mailing Address - Country:US
Mailing Address - Phone:206-473-2700
Mailing Address - Fax:877-376-6032
Practice Address - Street 1:2721 SW TRENTON ST
Practice Address - Street 2:#46565
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126
Practice Address - Country:US
Practice Address - Phone:206-473-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00003478101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty