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General NPI Number Information
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NPI Number | 1184900045
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Entity Type | Individual
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Provider Name | KAREN LEE BRASILE LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/24/2011
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 12590 WHITEHALL DR STE 3
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City | FORT MYERS
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State | FL
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Zip | 33907-4680
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Country | US
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Telephone | 239-939-9090
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Fax |
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Provider Business Mailing Address
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Address Line | 972 GREENWOOD COURT S
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City | SANIBEL
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State | FL
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Zip | 33957
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Country | US
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Telephone | 239-395-4610
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Fax | 239-395-4610
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW10521
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | #149.007381
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License Number State | IL
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