Provider Demographics
NPI:1366267528
Name:SARKIS, CARISSA
Entity type:Individual
Prefix:
First Name:CARISSA
Middle Name:
Last Name:SARKIS
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:478 CRYSTAL ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01832-1023
Mailing Address - Country:US
Mailing Address - Phone:978-852-9083
Mailing Address - Fax:
Practice Address - Street 1:6 EDGERLY PL FL 3
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-5327
Practice Address - Country:US
Practice Address - Phone:617-341-8209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health