Provider Demographics
NPI:1417740598
Name:CHRYSALIS DISABILITY SERVICES
Entity type:Organization
Organization Name:CHRYSALIS DISABILITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CHAIR
Authorized Official - Prefix:
Authorized Official - First Name:SICLINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTY-ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-819-1412
Mailing Address - Street 1:7533 WILLIAMSON RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24019-4301
Mailing Address - Country:US
Mailing Address - Phone:540-632-0849
Mailing Address - Fax:540-566-4472
Practice Address - Street 1:7533 WILLIAMSON RD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24019-4301
Practice Address - Country:US
Practice Address - Phone:540-632-0849
Practice Address - Fax:540-566-4472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty