NPIMap

Organization Active NPI

A Center for Mental Wellness Community Support Programs, LLC

Doing business as Chrysalis in Sussex at ACFMW

  • Adult Mental Health Clinic/Center
  • Dover, DE
National Provider Identifier
1427528678
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
A CENTER FOR MENTAL WELLNESS COMMUNITY SUPPORT PROGRAMS, LLC
Doing business as
Chrysalis in Sussex at ACFMW
Practice address
121 W Loockerman St
Dover, DE 19904-7325
Phone
(302) 674-1397
Fax
(302) 674-1602
NPI assigned
Nov 30, 2018
Organization subpart
Yes
Parent organization
A CENTER FOR MENTAL WELLNESS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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

Authorized official

Name
Lauren Elizabeth Tinsley, LPCMH
Title
Managing Member
Phone
(302) 674-1397

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

121 W Loockerman St
Dover, DE 19904-7325

Mailing address

121 W Loockerman St
Dover, DE 19904-7325
Phone (302) 674-1397

Other identifiers 1

IdentifierTypeStateIssuer
1639325822MedicaidDE

Other names 1

  • Chrysalis in Sussex at ACFMW Doing business as

National Provider Directory

National Provider Directory
Tax ID family
A Center for Mental Wellness Community Support Programs LLC10 organizations share this tax ID, including this one
Part of
A Center for Mental Wellness Inc

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543536000000",
    "number": "1427528678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 W LOOCKERMAN ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199047325",
            "telephone_number": "302-674-1397",
            "fax_number": "302-674-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W LOOCKERMAN ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199047325",
            "telephone_number": "302-674-1397",
            "fax_number": "302-674-1602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A CENTER FOR MENTAL WELLNESS COMMUNITY SUPPORT PROGRAMS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "A CENTER FOR MENTAL WELLNESS, INC.",
        "enumeration_date": "2018-11-30",
        "last_updated": "2018-11-30",
        "status": "A",
        "authorized_official_last_name": "TINSLEY",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "302-674-1397",
        "authorized_official_credential": "LPCMH"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639325822",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chrysalis in Sussex at ACFMW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dover, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; 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.