Tubman Family Alliance & Chrysalis A Center for Women Inc – Mental Health Clinic/Center (Including Community Mental Health Center), NPI 1376655159

Tubman Family Alliance & Chrysalis A Center for Women Inc is a healthcare provider. based in Minneapolis, Minnesota. specializing in Mental Health Clinic/Center (Including Community Mental Health Center). The organization holds a License No. 8004872MHC (MN). The NPI Number for Tubman Family Alliance & Chrysalis A Center for Women Inc is 1376655159

Main info

Organization
Name
Tubman Family Alliance & Chrysalis A Center for Women Inc
NPI
1376655159
Phone
(612) 870-2444
Address
4432 CHICAGO AVENUE SOUTH
Authorized Official
BEVERLY DUSSO EXECUTIVE DIRECTOR
Enumeration Date
31 August 2006
Last Update Date
4 November 2008
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Tubman Family Alliance & Chrysalis A Center for Women Inc

  • Tubman Chrysalis Center, 4432, Chicago Avenue South, Northrop, Regina, Minneapolis, Hennepin County, Minnesota, 55407, United States

    MINNEAPOLIS, MN 55407

    Phone: (612) 870-2444

    Fax: (612) 870-2428

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-05-03

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-11-30 (928 days ago).

Enrollment records

1

Earliest due date

2023-11-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040503001331OClinic/Group PracticeMN2023-11-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55407)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Tubman Family Alliance & Chrysalis A Center for Women Inc?
Tubman Family Alliance & Chrysalis A Center for Women Inc — NPI 1376655159 — is the standard way to identify this listing.
Does CMS list Tubman Family Alliance & Chrysalis A Center for Women Inc as active?
Yes — Tubman Family Alliance & Chrysalis A Center for Women Inc is active in the NPI listing used on this page.
What is Tubman Family Alliance & Chrysalis A Center for Women Inc best known for clinically?
Directory data describes Tubman Family Alliance & Chrysalis A Center for Women Inc with Mental Health Clinic/Center (Including Community Mental Health Center). Clinical services aligned with this taxonomy classification.
Does Tubman Family Alliance & Chrysalis A Center for Women Inc list a practice location?
Patients near Minneapolis, Minnesota may find Tubman Family Alliance & Chrysalis A Center for Women Inc in results; validate coverage separately.
What does 'Organization' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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