Provider Demographics
NPI:1912577867
Name:SANARE PSR PLLC
Entity Type:Organization
Organization Name:SANARE PSR PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:BRIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEVERINE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, LAC, CPRP
Authorized Official - Phone:562-618-2319
Mailing Address - Street 1:2463 S RALEIGH ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-5144
Mailing Address - Country:US
Mailing Address - Phone:562-618-2319
Mailing Address - Fax:
Practice Address - Street 1:1720 S BELLAIRE ST STE 909
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4333
Practice Address - Country:US
Practice Address - Phone:303-476-1974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty