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General NPI Number Information
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NPI Number | 1386775401
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Entity Type | Organization
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Legal Business Name | CHRYSALIS COUNSELING CENTERS
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1100 SUNSET LN SUITE 1310A
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City | CULPEPER
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State | VA
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Zip | 22701-3378
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Country | US
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Telephone | 540-727-0770
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Fax | 540-727-7310
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Provider Business Mailing Address
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Address Line | 1100 SUNSET LN SUITE 1310A
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City | CULPEPER
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State | VA
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Zip | 22701-3378
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Country | US
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Telephone | 540-727-0770
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Fax | 540-727-7310
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Authorized Official
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Title or Position | CEO
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Name | MRS. ELIZABETH ANN STEVENSON
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Credential | LCSW, PHD
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Telephone | 540-727-0770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904002202
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License Number State | VA
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