Provider Demographics
NPI:1649804634
Name:JACQUELINE R KAIRIS COUNSELING
Entity type:Organization
Organization Name:JACQUELINE R KAIRIS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAIRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PC
Authorized Official - Phone:302-897-7887
Mailing Address - Street 1:PO BOX 3753
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19807-0753
Mailing Address - Country:US
Mailing Address - Phone:302-588-9250
Mailing Address - Fax:302-416-5100
Practice Address - Street 1:3411 SILVERSIDE RD BLDG STE 109
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4812
Practice Address - Country:US
Practice Address - Phone:302-588-9520
Practice Address - Fax:302-416-5100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty