CHRYSALIS PSYCHOTHERAPY (NPI# 1063065175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063065175 |
| Entity Type | Organization |
| Organization Name | CHRYSALIS PSYCHOTHERAPY |
| Practice Address |
1173 W Main St Whitewater WI 53190-1672 |
| Mailing Address |
701 N Wuthering Hills Dr Janesville WI 53546-2104 |
| Practice Telephone | 6083020140 |
| Mailing Telephone | 6083020140 |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2019-07-17 |
| Authorized Official Name | MS. JULIE ANN MCCALIP (SOCIAL WORKER) |
| Authorized Official Telephone | 6083020140 |
| Authorized Official Credential | MSW, APSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
1173 W MAIN ST |
| City | WHITEWATER |
| State | WI |
| Zip Code | 53190-1672 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386610046 | Jason J Mackey | Chiropractor | 1173 W Main St, Whitewater, WI 53190-1672 | 2006-02-23 |
| 1609413061 | Marci A Rueter | Pharmacist | 1173 W Main St, Whitewater, WI 53190-1672 | 2019-12-04 |
| 1679125587 | Julie Mccalip | Social Worker | 1173 W Main St, Whitewater, WI 53190-1672 | 2019-07-10 |
| 1730745191 | Alana Elsie Everson | Pharmacist | 1173 W Main St, Whitewater, WI 53190-1672 | 2019-05-11 |
| 1578808002 | Sara Hathaway | Pharmacist | 1173 W Main St, Whitewater, WI 53190-1672 | 2012-12-10 |
| 1437313384 | Mc 5 Inc | Pharmacy | 1173 W Main St, Ste F, Whitewater, WI 53190-1672 | 2008-07-10 |
| 1740490739 | Robert Mccullough | Pharmacist | 1173 W Main St, Whitewater, WI 53190-1672 | 2007-05-22 |
| 1740359736 | John Schaaf Sheldon | Pharmacist | 1173 W Main St, Whitewater, WI 53190-1672 | 2006-11-06 |
| 1093824880 | Mc5 Inc | Pharmacy | 1173 W Main St, Whitewater, WI 53190-1672 | 2006-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962908608 | Shannon Bashor | Specialist/Technologist | 907 W Schwager Dr, Whitewater, WI 53190 | 2018-04-02 |
| 1922542695 | Terry Teipner | Counselor | 1173 W Main St Ste B, Whitewater, WI 53190 | 2016-12-14 |
| 1063800100 | Courtney Stefanski | Specialist/Technologist | 900 Schwager Drive, Whitewater, WI 53190 | 2014-12-23 |
| 1275942989 | Courtney Palubicki | Specialist/Technologist | 907 W. Schwager Drive, Whitewater, WI 53190 | 2014-08-06 |
| 1548491087 | Ann Marie Welch | Registered Nurse | 9640 N. County Line Rd, Whitewater, WI 53190 | 2009-07-31 |
| 1780801423 | Marsha Lee Mckinnon | Registered Nurse | 710 Starin Road, Whitewater, WI 53190 | 2007-04-20 |
| 1164599387 | Michael J Kellum | Emergency Medicine | W9575 Homburg Lane, Whitewater, WI 53190 | 2006-11-30 |
| 1861596371 | Brian William Veale | Chiropractor | 543 S Putnam St, Whitewater, WI 53190 | 2006-09-13 |
| 1629508908 | Erin Kae Clark | Specialist/Technologist | 800 W Main St, Williams Center 105g, Whitewater, WI 53190 | 2017-06-19 |
| 1952854150 | Rebecca K Hamman | Nurse Practitioner | 710 W Starin Rd, Whitewater, WI 53190 | 2016-07-25 |
| Find all providers in zip 53190 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730748724 | Molly Lubin Md LLC | Clinic/Center | 16 N Carroll St Ste 450-c, Madison, WI 53703-2716 | 2019-06-12 |
| 1346702826 | Kris Huenink Counseling Services LLC | Clinic/Center | 501 N 8th St Ste 110, Sheboygan, WI 53081-4461 | 2019-04-03 |
| 1720550981 | Purple Lotus Counseling LLC | Clinic/Center | 516 E Wisconsin Ave Ste C, Appleton, WI 54911-4864 | 2018-12-27 |
| 1831677079 | Creative Calm Counseling LLC | Clinic/Center | 2380 State Road 44 Ste G, Oshkosh, WI 54904-6440 | 2018-07-31 |
| 1407370398 | Tombolo, LLC | Clinic/Center | 12545 W. Burleigh Rd., Suite 10, Brookfield, WI 53005 | 2017-08-01 |
| 1730530239 | Home Away From Home Living Services LLC | Clinic/Center | 8127 W Herbert Ave, Milwaukee, WI 53218-3632 | 2016-06-26 |
| 1891149928 | Tcg Holdings 14, LLC | Clinic/Center | 127 N Franklin St Ste 206, Port Washington, WI 53074-1948 | 2016-04-14 |
| 1427410992 | Shelley Boehm Mattia Md,adult Psychiatry, LLC | Clinic/Center | 428 Doty St, Green Bay, WI 54301-4509 | 2016-03-24 |
| 1982002242 | Family & Childrens Center | Clinic/Center | 920 W Wisconsin St, Sparta, WI 54656-4217 | 2014-12-18 |
| 1154675924 | Northshore Clinic LLC | Clinic/Center | 805 N 6th St, Sheboygan, WI 53081-4113 | 2012-11-01 |
| Find all providers with the same taxonomy | ||||
| City | WHITEWATER |
| Zip Code | 53190 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.