Provider Demographics
NPI:1508548462
Name:REICHEL, CHRYSA (LGSW)
Entity Type:Individual
Prefix:
First Name:CHRYSA
Middle Name:
Last Name:REICHEL
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:CHRYSA
Other - Middle Name:
Other - Last Name:HUMPHREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2510 LEXINGTON AVE S
Mailing Address - Street 2:
Mailing Address - City:MENDOTA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55120-1260
Mailing Address - Country:US
Mailing Address - Phone:651-422-8850
Mailing Address - Fax:651-455-1385
Practice Address - Street 1:2510 LEXINGTON AVE. S
Practice Address - Street 2:
Practice Address - City:MENDOTA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55120
Practice Address - Country:US
Practice Address - Phone:651-280-5359
Practice Address - Fax:651-455-1385
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN28078104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker