Organization Active NPI

Chrysalis Counseling Coaching and Consulting LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Valparaiso, IN
National Provider Identifier
1356937254
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
CHRYSALIS COUNSELING COACHING AND CONSULTING LLC
Doing business as
Chrysalis Counseling, Coaching, and Consulting, LLC
Practice address
1918 Garland Circle Dr
Valparaiso, IN 46383-1161
Phone
(773) 345-7529
NPI assigned
Dec 15, 2020
Last updated
Nov 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Authorized official

Name
Sameka R Dowell Mills, NP
Title
Advanced Practice Nurse
Phone
(219) 286-2764

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1918 Garland Circle Dr
Valparaiso, IN 46383-1161

Mailing address

18125 Roy St Unit 622
Lansing, IL 60438-6655

Other names 1

  • Chrysalis Counseling, Coaching, and Consulting, LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, IL, IN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20230517003575 CO Part B Supplier - Clinic/Group Practice 1557727583 Receives reassigned benefits from 1 practitioner
Practice locations: Denver, CO
O20230810003038 IL Part B Supplier - Clinic/Group Practice 1557727583 Receives reassigned benefits from 1 practitioner
Practice locations: Lansing, IL
O20230822003376 IN Part B Supplier - Clinic/Group Practice 1557727583 Practice locations: Valparaiso, IN

National Provider Directory

National Provider Directory

Locations

18125 Roy St
Unit 622
Lansing, IL 60438
Phone (773) 219-6483

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732665600000",
    "number": "1356937254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18125 ROY ST UNIT 622",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604386655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 GARLAND CIRCLE DR",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463831161",
            "telephone_number": "773-345-7529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIS COUNSELING COACHING AND CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-15",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A",
        "authorized_official_last_name": "DOWELL MILLS",
        "authorized_official_first_name": "SAMEKA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADVANCED PRACTICE NURSE",
        "authorized_official_telephone_number": "219-286-2764",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chrysalis Counseling, Coaching, and Consulting, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chrysalis Counseling, Coaching, and Consulting, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.