Organization · NPI-2

Khrysalis Empowerment INC.

Counselor, Mental Health · Ellenwood, GA

NPI number1952169153
StatusActive
Last updated in NPPESJun 8, 2026

Details

NPI
1952169153
Entity type
Organization (NPI-2)
Legal business name
Khrysalis Empowerment INC.
Organization subpart
No
Enumeration date
Mar 12, 2024
Certification date
Jun 8, 2026
Last updated
Jun 8, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental Health––Yes
261QM0850X Clinic/Center, Adult Mental Health––
251B00000X Case Management––
251V00000X Voluntary or Charitable––

Other names

  • Khrysalis Empowerment INC (Doing Business As)

Practice location

168 Expedition Dr
Ellenwood, GA 30294-2274

Phone 770-703-9008

Mailing address

168 Expedition Dr
Ellenwood, GA 30294-2274

Phone 770-703-9008

Authorized official

Diann Shahid
Ceo/Founder
7707039008

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Counselor, Mental Health providers in Ellenwood, GA