Provider Demographics
NPI:1003273665
Name:CARIS COUNSELING & BEHAVIORAL HEALTH GROUP
Entity Type:Organization
Organization Name:CARIS COUNSELING & BEHAVIORAL HEALTH GROUP
Other - Org Name:CARIS COUNSELING
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHELLIE
Authorized Official - Middle Name:LAINE
Authorized Official - Last Name:GARY-CHEIRS
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:270-871-2877
Mailing Address - Street 1:108 S MAIN ST STE 104
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-2580
Mailing Address - Country:US
Mailing Address - Phone:270-681-2273
Mailing Address - Fax:270-905-3176
Practice Address - Street 1:108 S MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-2580
Practice Address - Country:US
Practice Address - Phone:270-681-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty