Provider Demographics
NPI:1346044377
Name:CHRYSALIS THERAPY PLLC
Entity type:Organization
Organization Name:CHRYSALIS THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:JOANNE
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:517-290-4846
Mailing Address - Street 1:1491 SPENCER ST
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-3505
Mailing Address - Country:US
Mailing Address - Phone:517-290-4846
Mailing Address - Fax:
Practice Address - Street 1:628 E PARENT AVE STE 505
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-3769
Practice Address - Country:US
Practice Address - Phone:313-451-0305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty