Provider Demographics
NPI:1558736884
Name:SARIS COUNSELING
Entity Type:Organization
Organization Name:SARIS COUNSELING
Other - Org Name:EVOLVE
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELISSARIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSE, LPC, NCC
Authorized Official - Phone:920-364-9078
Mailing Address - Street 1:3416 N ASSOCIATION DR
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-1479
Mailing Address - Country:US
Mailing Address - Phone:920-364-9078
Mailing Address - Fax:920-243-1792
Practice Address - Street 1:3416 N ASSOCIATION DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-1479
Practice Address - Country:US
Practice Address - Phone:920-364-9078
Practice Address - Fax:920-243-1792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5873125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty