Organization
CHRYSALIS BEHAVIORAL HEALTH SERVICES AND TRAINING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA MARIE CAVETT PHD (CLINICAL DIRECTOR, PSYCHOLOGIST)
(701) 260-0713
Entity
Organization
Contact information
Practice address
1620 16TH AVE S, FARGO, ND 58103-4055
(701) 260-0713
Mailing address
102 W BEATON DR STE 103, WEST FARGO, ND 58078-2653
(701) 260-0713
(701) 356-4940
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/30/2018
Last updated
03/12/2019
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