Chrysalis Wellness LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CHRYSALIS WELLNESS LLC

Practice address

4659 NE Ainsworth St
Portland, OR 97218-1849

Phone

(503) 451-0079

Fax

(503) 486-3527

NPI assigned

Sep 4, 2025

Organization subpart

No

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

Authorized official

Name

Ajna RaeNPI 1124633326

Title

Owner

Phone

(503) 451-0079

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ajna Rae

  • Mental Health Counselor
  • Portland, OR
  • NPI 1124633326
  NPD Authorized official

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

{
    "created_epoch": "1756944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756944000000",
    "number": "1366322935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4659 NE AINSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972181849",
            "telephone_number": "503-451-0079",
            "fax_number": "503-486-3527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4659 NE AINSWORTH ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972181849",
            "telephone_number": "503-451-0079",
            "fax_number": "503-486-3527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIS WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "RAE",
        "authorized_official_first_name": "AJNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-451-0079"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David M Christy, LMFT
• James Snider Christy, D.C.
• Kyle Jeffrey Christy
• Sherri L Chritton, RN, CNOR RNFA
• Chrysalis Mental Health LLC
• Chrystal Shaw LMT
• Adrian Chu, CRNA, RN
• Charles Chu
• Cong-Qiu Chu, MD
• Julian Chu

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; 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.