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Organization
CHRYSALIS INSTITUTE, LLC
Active
Organization
CHRYSALIS INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLY BENDER LPC (PRESIDENT/THERAPIST)
(405) 301-3983
Entity
Organization
Contact information
Practice address
800 NE 19TH ST, MOORE, OK 73160-6302
(405) 735-5263
(405) 735-5265
Mailing address
800 NE 19TH ST, MOORE, OK 73160-6302
(405) 735-5263
(405) 735-5265
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
08/06/2009
Last updated
08/06/2009
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