| Chrysalis Counseling Florida Llc | |
|
2028 Brendla Rd Clearwater FL 33755-1309 | |
| (314) 780-8328 | |
| Not Available |
| Full Name | Chrysalis Counseling Florida Llc |
|---|---|
| Speciality | Counselor |
| Location | 2028 Brendla Rd, Clearwater, Florida |
| Authorized Official Name and Position | Claudine Miller (OWNER) |
| Authorized Official Contact | 3147808328 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chrysalis Counseling Florida Llc 2028 Brendla Rd Clearwater FL 33755-1309 Ph: (314) 780-8328 | Chrysalis Counseling Florida Llc 2028 Brendla Rd Clearwater FL 33755-1309 Ph: (314) 780-8328 |
| NPI Number | 1679332563 |
|---|---|
| Provider Enumeration Date | 03/14/2024 |
| Last Update Date | 03/14/2024 |
| Certification Date | 03/14/2024 |
| Medicare PECOS PAC ID | 6406294974 |
|---|---|
| Medicare Enrollment ID | O20240403000216 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679332563 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| Provider Name | Claudine Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841587607 PECOS PAC ID: 7214375781 Enrollment ID: I20240403000405 |
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