| Chrysalis Center | |
|
3321 49th St N St Petersburg FL 33710-2145 | |
| (727) 743-9060 | |
| (727) 367-4139 |
| Full Name | Chrysalis Center |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3321 49th St N, St Petersburg, Florida |
| Authorized Official Name and Position | Joan S Mason (OWNER) |
| Authorized Official Contact | 7277439060 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chrysalis Center 200 1st Ave #305 St Pete Beach FL 33706-4364 Ph: (727) 744-4880 | Chrysalis Center 3321 49th St N St Petersburg FL 33710-2145 Ph: (727) 743-9060 |
| NPI Number | 1538207667 |
|---|---|
| Provider Enumeration Date | 02/01/2007 |
| Last Update Date | 11/16/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538207667 | NPI | - | NPPES |
| 7940163 | Other | FL | AETNA |
| P4510 | Other | FL | MEDICARE SENDER/SUBMITTER |
| 1538207667 | Other | FL | MEDICARE PROVIDER ID 1538207667 |
| 182234000 | Other | FL | MAGELLAN |
| AK104 | Other | FL | MEDICARE GROUP PTAN |
| 4014110 | Other | FL | HUMANA |
| Z8210Z | Other | FL | MEDICARE PTAN |
| 0739204 | Other | FL | CIGNA |
| 512778450 | Other | UNITED BEHAVIORAL HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW4600 (Florida) | Primary |
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