Active NPI
Chrysalis Counseling Coaching and Consulting LLC
- Psychiatric/Mental Health Nurse Practitioner
- Valparaiso, IN
National Provider Identifier
1356937254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- 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, 2024
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO, IL, IN
Enrollment records 3
National Provider Directory
National Provider DirectoryLocations
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.