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General NPI Number Information
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NPI Number | 1083357958
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Entity Type | Organization
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Legal Business Name | CHRYSALIS COUNSELING AND CONSULTING, LLC
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Dates
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Enumeration Date | 04/18/2022
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Last Update Date | 04/22/2022
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Provider Practice Location Address
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Address Line | 3617 WATERWHEEL SQ
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-2619
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Country | US
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Telephone | 410-929-0374
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Fax |
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Provider Business Mailing Address
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Address Line | 3617 WATERWHEEL SQ
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-2619
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER AND PSYCHOTHERAPIST
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Name | BRITTANY J SOTHERN
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Credential | LCPC
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Telephone | 410-929-0374
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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