Chrysalis Psychological Services, PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CHRYSALIS PSYCHOLOGICAL SERVICES, PLLC

Practice address

156 W Michigan Ave Ste 525
Jackson, MI 49201-1302

Phone

(517) 262-0198

NPI assigned

Oct 3, 2021

Organization subpart

No

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

Authorized official

Name

Jayde Kennedy-Ball, PSYD, LP, CBISNPI 1225345077

Title

Owner

Phone

(517) 262-0198

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

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

• Jayde Kennedy-Ball, PSYD, LP

  • Clinical Psychologist
  • Jackson, MI
  • NPI 1225345077
  Medicare reassignment NPD Authorized official
• Darcie Burdick

  • Clinical Social Worker
  • Jackson, MI
  • NPI 1164898458
  NPD (past)

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

{
    "created_epoch": "1633219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633219200000",
    "number": "1407528920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 W MICHIGAN AVE STE 525",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011302",
            "telephone_number": "517-262-0198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 W MICHIGAN AVE STE 525",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011302",
            "telephone_number": "517-262-0198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIS PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-03",
        "last_updated": "2021-10-03",
        "certification_date": "2021-09-13",
        "status": "A",
        "authorized_official_last_name": "KENNEDY-BALL",
        "authorized_official_first_name": "JAYDE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-262-0198",
        "authorized_official_credential": "PSYD, LP, CBIS"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "chrysalispsychologicalservices@gmail.com",
            "affiliation": "N",
            "address_1": "156 W Michigan Ave Ste 525",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492011302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christ Centered Homes, Inc.
• Tracina Christensen, FNP-C
• Christine Irene Peterson, LLC
• David W Christophel, CRNA
• Heather R. Chruch, LLPC
• Hrag Churukian, DO
• Christina Cieslik
• Teresa Cipparone
• Kylie Michelle Claffey, LLMSW
• Paulette R Clair, PHARMD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Jackson, MI
• Providers in Jackson, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2021; 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.