Organization Name: | CHRYSALIS CONNECTION PLLC |
NPI Number: | 1558789750 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NICHELLE D WILLIAMS (LICENSED ALCOHOL AND DRUG COUNSELOR) |
Mailing Address: | 1401 S Douglas Blvd Ste. A Midwest City |
State: | OK US |
Postal Code: | 731305266 |
Phone Number: | 4057372065 |
Fax Number: | |
NPI Enumeration Date: | 04/03/2014 |
NPI Last Update Date: | 04/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 1036 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |