The Chrysalis Group, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05206200 Issued in NJ

Legal business name

THE CHRYSALIS GROUP, LLC

Practice address

33-11 Broadway Ste 201
Fair Lawn, NJ 07410-4638

Phone

(201) 873-8583

Fax

(201) 794-0962

NPI assigned

Mar 28, 2008

Last updated

Mar 28, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Francine Gordon, LCSWNPI 1124186457

Title

Managing Partner

Phone

(201) 873-8583

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Francine Gordon, LCSW

  • Clinical Social Worker
  • Ridgewood, NJ
  • NPI 1124186457
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206662400000",
    "number": "1215109301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33-11 BROADWAY STE 201",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074104638",
            "telephone_number": "201-873-8583",
            "fax_number": "201-794-0962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33-11 BROADWAY STE 201",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074104638",
            "telephone_number": "201-873-8583",
            "fax_number": "201-794-0962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHRYSALIS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-28",
        "last_updated": "2008-03-28",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "FRANCINE",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "201-873-8583",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05206200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.