| Chrysalis Family Solutions, Llc | |
|
201 E Liberty St Ste 140 Wooster OH 44691-4325 | |
| (330) 439-5651 | |
| (330) 439-5657 |
| Full Name | Chrysalis Family Solutions, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 201 E Liberty St Ste 140, Wooster, Ohio |
| Authorized Official Name and Position | Angela Earley (OWNER) |
| Authorized Official Contact | 3304665640 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chrysalis Family Solutions, Llc 201 E Liberty St Ste 140 Wooster OH 44691-4325 Ph: (330) 439-5651 | Chrysalis Family Solutions, Llc 201 E Liberty St Ste 140 Wooster OH 44691-4325 Ph: (330) 439-5651 |
| NPI Number | 1477063238 |
|---|---|
| Provider Enumeration Date | 10/06/2017 |
| Last Update Date | 08/15/2023 |
| Certification Date | 08/15/2023 |
| Medicare PECOS PAC ID | 3971850660 |
|---|---|
| Medicare Enrollment ID | O20180726001763 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477063238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | James B Foley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912195363 PECOS PAC ID: 6406933506 Enrollment ID: I20080414000061 |
| Provider Name | Angela P Earley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174502306 PECOS PAC ID: 6204985690 Enrollment ID: I20090513000602 |
| Provider Name | Gina Patterson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255502654 PECOS PAC ID: 4284932344 Enrollment ID: I20160406001478 |
| Provider Name | Sarah Robb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790091262 PECOS PAC ID: 8628355757 Enrollment ID: I20170427001521 |
| Provider Name | David G Earley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346360641 PECOS PAC ID: 0648532093 Enrollment ID: I20180322001486 |
| Provider Name | Mary C Stockton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083131312 PECOS PAC ID: 6507111234 Enrollment ID: I20180620001063 |
| Provider Name | Emily A Engman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659921153 PECOS PAC ID: 5698139202 Enrollment ID: I20230915000704 |
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