Organization Active NPI

Chrysalis Disability Services

Doing business as Chrysalis Roanoke

  • Clinical Social Worker
  • Roanoke, VA
National Provider Identifier
1417740598
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CHRYSALIS DISABILITY SERVICES
Doing business as
Chrysalis Roanoke
Practice address
7533 Williamson Rd
Roanoke, VA 24019-4301
Phone
(540) 632-0849
Fax
(540) 566-4472
NPI assigned
May 22, 2025
Last updated
May 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Authorized official

Name
Siclinda Canty-Elliott
Title
Board Chair
Phone
(540) 819-1412

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

7533 Williamson Rd
Roanoke, VA 24019-4301

Mailing address

7533 Williamson Rd
Roanoke, VA 24019-4301
Phone (540) 632-0849

Other names 1

  • Chrysalis Roanoke Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1417740598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7533 WILLIAMSON RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240194301",
            "telephone_number": "540-632-0849",
            "fax_number": "540-566-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7533 WILLIAMSON RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240194301",
            "telephone_number": "540-632-0849",
            "fax_number": "540-566-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIS DISABILITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "CANTY-ELLIOTT",
        "authorized_official_first_name": "SICLINDA",
        "authorized_official_title_or_position": "BOARD CHAIR",
        "authorized_official_telephone_number": "540-819-1412"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chrysalis Roanoke",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.