Organization Active NPI

Chrysalis Health Services P.C.

  • Clinical Social Worker
  • Oklahoma City, OK
National Provider Identifier
1780975375
Registry record updated Apr 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3950 Issued in OK
Legal business name
CHRYSALIS HEALTH SERVICES P.C.
Practice address
3033 N Walnut Ave
West Building, 2ND Floor (Miraworx)
Oklahoma City, OK 73105-2832
Phone
(405) 230-1183
NPI assigned
Apr 29, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2011

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

Authorized official

Name
Mr. David Nickell, L.C.S.W.
Title
Therapist/Owner
Phone
(405) 230-1183

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 3950 OK Primary

Addresses

Primary practice location

3033 N Walnut Ave
West Building, 2ND Floor (Miraworx)
Oklahoma City, OK 73105-2832

Mailing address

3033 North Walnut
Oklahoma City, OK 73105
Phone (405) 230-1183

National Provider Directory

National Provider Directory

Locations

3033 N Walnut Ave
Bldg 2ND
Oklahoma City, OK 73105
Phone (405) 230-1183

NPI Registry JSON

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

{
    "created_epoch": "1304035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304035200000",
    "number": "1780975375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 NORTH WALNUT",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73105",
            "telephone_number": "405-230-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 N WALNUT AVE",
            "address_2": "WEST BUILDING, 2ND FLOOR (MIRAWORX)",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731052832",
            "telephone_number": "405-230-1183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIS HEALTH SERVICES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-29",
        "last_updated": "2011-04-29",
        "status": "A",
        "authorized_official_last_name": "NICKELL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "405-230-1183",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "3950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2011; 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.