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General NPI Number Information
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NPI Number | 1790997385
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Entity Type | Organization
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Legal Business Name | CHRYSALIS COUNSELING, P. C.
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 10/09/2009
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Provider Practice Location Address
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Address Line | 3609 CEDAR SPRINGS RD
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City | DALLAS
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State | TX
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Zip | 75219-4905
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Country | US
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Telephone | 214-528-3007
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Fax |
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Provider Business Mailing Address
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Address Line | 3609 CEDAR SPRINGS RD
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City | DALLAS
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State | TX
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Zip | 75219-4905
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Country | US
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Telephone | 214-528-3007
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | DR. CAROL MCEWEN PHELPS
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Credential | PH. D. LMFT
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Telephone | 214-528-3007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 2035
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License Number State | TX
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