Provider Demographics
NPI:1649482860
Name:CHRYSALIS COUNSELING CENTER
Entity type:Organization
Organization Name:CHRYSALIS COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR AND CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:540-727-0770
Mailing Address - Street 1:1100 SUNSET LANE
Mailing Address - Street 2:SUITE 1310A
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701
Mailing Address - Country:US
Mailing Address - Phone:540-727-0770
Mailing Address - Fax:540-727-7310
Practice Address - Street 1:7250 GARDNER PARK DRIVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155
Practice Address - Country:US
Practice Address - Phone:703-753-7773
Practice Address - Fax:703-753-0723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003772101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty