Healthcare Provider Details

I. General information

NPI: 1235981366
Provider Name (Legal Business Name): CHRYSALIS THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2024
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 ROUTE 38 STE 164
CHERRY HILL NJ
08002-2975
US

IV. Provider business mailing address

535 ROUTE 38 STE 164
CHERRY HILL NJ
08002-2975
US

V. Phone/Fax

Practice location:
  • Phone: 908-336-4537
  • Fax:
Mailing address:
  • Phone: 908-336-4537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA MERCADO
Title or Position: OWNER/THERAPIST
Credential: LPC
Phone: 908-336-4537