Provider Demographics
NPI:1568932721
Name:A CENTER FOR MENTAL WELLNESS, INC.
Entity Type:Organization
Organization Name:A CENTER FOR MENTAL WELLNESS, INC.
Other - Org Name:CHRYSALIS IN NEW CASTLE AT ACFMW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:TINSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPCMH
Authorized Official - Phone:302-674-1397
Mailing Address - Street 1:25 S OLD BALTIMORE PIKE
Mailing Address - Street 2:LAFAYETTE BUILDING 1, SUITE 201
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702
Mailing Address - Country:US
Mailing Address - Phone:302-266-6200
Mailing Address - Fax:302-266-6212
Practice Address - Street 1:25 S OLD BALTIMORE PIKE
Practice Address - Street 2:LAFAYETTE BUILDING 1, SUITE 201
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702
Practice Address - Country:US
Practice Address - Phone:302-266-6200
Practice Address - Fax:302-266-6212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-30
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1639325822Medicaid