| Chrysalis Behavior Services | |
|
13887 Jeffrey Mine Road Johnston City IL 62951 | |
| (618) 521-7177 | |
| (314) 667-3167 |
| Full Name | Chrysalis Behavior Services |
|---|---|
| Speciality | Behavior Analyst |
| Location | 13887 Jeffrey Mine Road, Johnston City, Illinois |
| Authorized Official Name and Position | Christine Marie Littlebo (OWNER) |
| Authorized Official Contact | 6185217177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chrysalis Behavior Services 13887 Jeffery Mine Rd Johnston City IL 62951-2925 Ph: (618) 521-7177 | Chrysalis Behavior Services 13887 Jeffrey Mine Road Johnston City IL 62951 Ph: (618) 521-7177 |
| NPI Number | 1093230625 |
|---|---|
| Provider Enumeration Date | 08/04/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093230625 | NPI | - | NPPES |
| 1-14-9714 | Other | BEHAVIOR ANALYST CERTIFICATION BOARD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-14-9714 (* (Not Available)) | Primary |
Shawnee Health Service And Development Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 E 12th St, Johnston City, IL 62951 Phone: 618-519-9200 Fax: 618-998-0880 | |
Nova M. Griffith, Ph.d., Psychological Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 E Broadway Blvd, Johnston City, IL 62951 Phone: 618-969-2922 | |
Shawnee Health Service And Development Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1108 Grand Ave, Johnston City, IL 62951 Phone: 618-519-9200 Fax: 618-985-4635 | |
Shawnee Health Service And Development Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 Jefferson Ave, Johnston City, IL 62951 Phone: 618-519-9200 Fax: 618-998-0880 |