Chrysalis Health and Wellness

Primary specialty

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

Legal business name

CHRYSALIS HEALTH AND WELLNESS

Practice address

1005 E State St Ste E
Athens, OH 45701-2151

Phone

(740) 200-0784

NPI assigned

Aug 29, 2020

Organization subpart

No

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

Authorized official

Name

Dona Alba, DO

Title

Medical Director

Phone

(740) 200-0784

Specialties & licenses 1

Addresses

Tax ID family

Chrysalis Health and Wellness2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Chrysalis Health and Wellness

  • Primary Care Clinic/Center
  • Athens, OH
  • NPI 1013520014
  NPD tax ID

Locations

Practitioners 1

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

• Abigail M Ament, RN

  • Registered Nurse
  • Athens, OH
  • NPI 1649752486
  NPD

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

{
    "created_epoch": "1598659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611619200000",
    "number": "1417560335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ANNETTE DR",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457013441",
            "telephone_number": "847-402-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 E STATE ST STE E",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457012151",
            "telephone_number": "740-200-0784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIS HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-29",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A",
        "authorized_official_last_name": "ALBA",
        "authorized_official_first_name": "DONA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "740-200-0784",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moujgan Choubdar, CT
• Jessica Christa
• Maximilian Christiansen
• Samantha D Christopher, PH.D.
• Chrysalis Health and Wellness
• Traci Church
• Aaron Cibel
• Renee Cinquepalmi
• Clairessa Ciupak, PHARMD
• Kubra Civan

• Mental Health Clinic/Center (Including Community Mental Health Center) in Athens, OH
• Providers in Athens, OH by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.