| Chrysalis Health Ohio, Llc | |
|
5250 Strawberry Farms Blvd Columbus OH 43230 | |
| (813) 965-1629 | |
| Not Available |
| Full Name | Chrysalis Health Ohio, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5250 Strawberry Farms Blvd, Columbus, Ohio |
| Authorized Official Name and Position | Lewis Woodell (DIRECTOR OF RCM) |
| Authorized Official Contact | 8172916293 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chrysalis Health Ohio, Llc 5250 Strawberry Farms Blvd Columbus OH 43230-1049 Ph: (813) 965-1629 | Chrysalis Health Ohio, Llc 5250 Strawberry Farms Blvd Columbus OH 43230 Ph: (813) 965-1629 |
| NPI Number | 1003302886 |
|---|---|
| Provider Enumeration Date | 07/05/2018 |
| Last Update Date | 03/15/2022 |
| Certification Date | 03/15/2022 |
| Medicare PECOS PAC ID | 0941610919 |
|---|---|
| Medicare Enrollment ID | O20201102002379 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003302886 | NPI | - | NPPES |
| 0351215 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Francis A Sunseri |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1932106028 PECOS PAC ID: 2163494675 Enrollment ID: I20040806000176 |
| Provider Name | Prabhjot S Deol |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710947544 PECOS PAC ID: 1153414248 Enrollment ID: I20070906000020 |
| Provider Name | Rhonda J. Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326325622 PECOS PAC ID: 5092961102 Enrollment ID: I20120806000443 |
| Provider Name | Navdeep S Purewal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881663094 PECOS PAC ID: 6305879792 Enrollment ID: I20130327000549 |
| Provider Name | Dana Sue Sefsick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457773533 PECOS PAC ID: 4880813153 Enrollment ID: I20140918001169 |
| Provider Name | Kelly A Lean |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386000255 PECOS PAC ID: 2961783170 Enrollment ID: I20161230001413 |
| Provider Name | Trisha R Newland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952725509 PECOS PAC ID: 2466771134 Enrollment ID: I20170213002378 |
| Provider Name | Robert Block |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255616884 PECOS PAC ID: 9032451968 Enrollment ID: I20190425000520 |
| Provider Name | Brittany Mendenhall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528558764 PECOS PAC ID: 5294151643 Enrollment ID: I20200814002139 |
| Provider Name | Anyi E.a. Asongacha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275862633 PECOS PAC ID: 5698182335 Enrollment ID: I20210325001291 |
| Provider Name | Amy T Merker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619223906 PECOS PAC ID: 4587050760 Enrollment ID: I20220416000251 |
| Provider Name | Loretta E. Buckwalter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194337022 PECOS PAC ID: 2769856251 Enrollment ID: I20230323003120 |
| Provider Name | Tammy M Blackmon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386336170 PECOS PAC ID: 2163885435 Enrollment ID: I20230905001072 |
| Provider Name | Cassandra Channell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306361456 PECOS PAC ID: 6305205188 Enrollment ID: I20240223001506 |
| Provider Name | Anthony J Raterman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922351022 PECOS PAC ID: 1951747492 Enrollment ID: I20240307000311 |
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