# CHRYSALIS COUNSELING AND CONSULTATION CENTER, INC,

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295111581
- **Authorized official:** DR. GARY L KLING D. MIN., LPC (EXECUTIVE DIRECTOR / COUNSELOR)
- **Authorized official phone:** (336) 852-0626

## Contact information

- **Practice address:** 612 PASTEUR DR, SUITE 405, GREENSBORO, NC 27403-1149
- **Practice address phone:** (336) 852-0626
- **Practice address fax:** (336) 856-7703
- **Mailing address:** 612 PASTEUR DRIVE, SUITE 405, GREENSBORO, NC 27403-1120
- **Mailing address phone:** (336) 852-0626
- **Mailing address fax:** (336) 856-7703

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP1600X | Pastoral Counselor | 2390 | NC | Yes |

## Other

- **Enumeration date:** 08/10/2015
- **Last updated:** 08/10/2015