NPI 1265663363 · live from the CMS NPI Registry
Chrysalis Institute, LLC
Counselor, Mental Health in Moore, OK. National Provider Identifier 1265663363, active.
NPI record
| NPI | 1265663363 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Mental Health 101YM0800X |
| Practice location | 800 Ne 19th St, Moore, OK 73160 |
| Practice phone | 405-735-5263 |
| Enumerated | August 6, 2009 |
| Last updated | August 6, 2009 |
| Authorized official | Kelly Bender, President/Therapist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Professional | 101YP2500X | — |
| Marriage & Family Therapist | 106H00000X | — |
| Community/Behavioral Health | 251S00000X | — |
| Counselor, Mental Health primary | 101YM0800X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.