Organization
CHRYSALIS COMMUNITY COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MATHIESEN MPA (EXECUTIVE DIRECTOR)
(707) 545-1670
Entity
Organization
Contact information
Practice address
1821 4TH ST, SANTA ROSA, CA 95404-3202
(707) 545-7670
(707) 545-3715
Mailing address
1821 4TH ST, SANTA ROSA, CA 95404-3202
(707) 545-7670
(707) 545-3715
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
CA
Other
Enumeration date
10/14/2015
Last updated
10/14/2015
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