Healthcare Provider Details

I. General information

NPI: 1417876111
Provider Name (Legal Business Name): CHRYSALIS COUNSELING AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 GRISWOLD ST SE
GRAND RAPIDS MI
49507-3814
US

IV. Provider business mailing address

1215 GRISWOLD ST SE
GRAND RAPIDS MI
49507-3814
US

V. Phone/Fax

Practice location:
  • Phone: 616-987-4683
  • Fax: 828-340-1177
Mailing address:
  • Phone: 616-987-4683
  • Fax: 828-340-1177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KAYLA GRZECH
Title or Position: OWNER
Credential: LMSW
Phone: 616-987-4683