Chrysalis Community Counseling Services

Primary specialty

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

Legal business name

CHRYSALIS COMMUNITY COUNSELING SERVICES

Practice address

1821 4TH St
Santa Rosa, CA 95404-3202

Phone

(707) 545-7670

Fax

(707) 545-3715

NPI assigned

Oct 14, 2015

Organization subpart

No

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

Authorized official

Name

Lisa Mathiesen, MPA

Title

Executive Director

Phone

(707) 545-1670

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.

• Carmen Carnes

  • Community Health Worker
  • Santa Rosa, CA
  • NPI 1396190468
  NPD (past)

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444780800000",
    "number": "1780055897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 4TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954043202",
            "telephone_number": "707-545-7670",
            "fax_number": "707-545-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 4TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954043202",
            "telephone_number": "707-545-7670",
            "fax_number": "707-545-3715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIS COMMUNITY COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-14",
        "last_updated": "2015-10-14",
        "status": "A",
        "authorized_official_last_name": "MATHIESEN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "707-545-1670",
        "authorized_official_credential": "MPA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Christenson
• Michele Leanne Christiansen
• Christine Ferrera, PH.D, Psychological Corporation
• Nicole Amina Christofferson
• Colleen J Christou, DETOX COUNSELOR I
• Emma Chu
• Kenneth Chu, O.D.
• Joseph Benzon Chua, PT
• Loretta T Chuckrow
• Huldah Susan Chuenyane, PT25719

• Mental Health Clinic/Center (Including Community Mental Health Center) in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; 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.