Provider Demographics
NPI:1316248263
Name:CARIS COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:CARIS COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:702-355-9183
Mailing Address - Street 1:4284 RIDGEDALE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-2650
Mailing Address - Country:US
Mailing Address - Phone:702-355-9183
Mailing Address - Fax:
Practice Address - Street 1:4284 RIDGEDALE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-2650
Practice Address - Country:US
Practice Address - Phone:702-355-9183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5789-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty