Organization Active NPI

Jacqueline R Kairis Counseling

  • Professional Counselor
  • Wilmington, DE
National Provider Identifier
1649804634
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
JACQUELINE R KAIRIS COUNSELING
Practice address
3411 Silverside Rd BLDG Ste 109
Wilmington, DE 19810-4812
Phone
(302) 588-9520
Fax
(302) 416-5100
NPI assigned
Feb 27, 2020
Last updated
Feb 27, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jacqueline Kairis, PCNPI 1508409137
Title
Owner
Phone
(302) 897-7887

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

3411 Silverside Rd BLDG Ste 109
Wilmington, DE 19810-4812

Mailing address

PO Box 3753
Greenville, DE 19807-0753
Phone (302) 588-9250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250905000603 DE Part B Supplier - Clinic/Group Practice 8123527058 Receives reassigned benefits from 1 practitioner
Practice locations: Wilmington, DE

National Provider Directory

National Provider Directory

Locations

3411 Silverside Rd
Ste 109
Wilmington, DE 19810
Phone (302) 478-6525

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582761600000",
    "number": "1649804634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3753",
            "city": "GREENVILLE",
            "state": "DE",
            "postal_code": "198070753",
            "telephone_number": "302-588-9250",
            "fax_number": "302-416-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 SILVERSIDE RD BLDG STE 109",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104812",
            "telephone_number": "302-588-9520",
            "fax_number": "302-416-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELINE R KAIRIS COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-27",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A",
        "authorized_official_last_name": "KAIRIS",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-897-7887",
        "authorized_official_credential": "PC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.