Active NPI
Chrysalis Health Services P.C.
- Clinical Social Worker
- Oklahoma City, OK
National Provider Identifier
1780975375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3950
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 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 DirectoryLocations
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.