| Chrysalis Center For Counseling And Eating Disorder Treatment Pllc | |
|
3240 Burnt Mill Dr Ste 1 Wilmington NC 28403-2570 | |
| (910) 790-9500 | |
| (910) 796-8111 |
| Full Name | Chrysalis Center For Counseling And Eating Disorder Treatment Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 3240 Burnt Mill Dr Ste 1, Wilmington, North Carolina |
| Authorized Official Name and Position | Macon Funderburk (OFFICE MANAGER) |
| Authorized Official Contact | 9107909500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chrysalis Center For Counseling And Eating Disorder Treatment Pllc 3240 Burnt Mill Dr Ste 101 Wilmington NC 28403-2576 Ph: (910) 790-9500 | Chrysalis Center For Counseling And Eating Disorder Treatment Pllc 3240 Burnt Mill Dr Ste 1 Wilmington NC 28403-2570 Ph: (910) 790-9500 |
| NPI Number | 1891865218 |
|---|---|
| Provider Enumeration Date | 11/09/2006 |
| Last Update Date | 08/21/2024 |
| Certification Date | 08/21/2024 |
| Medicare PECOS PAC ID | 4183765068 |
|---|---|
| Medicare Enrollment ID | O20100114000432 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891865218 | NPI | - | NPPES |
| 355080 | Other | NC | MHN/TRICARE |
| 018AM | Other | NC | BCBS |
| Provider Name | Kerri S Schroder |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205978681 PECOS PAC ID: 7618162694 Enrollment ID: I20161012000964 |
| Provider Name | Shamika Bryant Huskey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245612506 PECOS PAC ID: 2769724590 Enrollment ID: I20190426002364 |
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