Provider Demographics
NPI:1144421660
Name:FAGIOLI, KAREN GAIL (LMSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:GAIL
Last Name:FAGIOLI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 ADAMS ST E
Mailing Address - Street 2:
Mailing Address - City:EAST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11730-1617
Mailing Address - Country:US
Mailing Address - Phone:631-277-8328
Mailing Address - Fax:
Practice Address - Street 1:49 ADAMS ST E
Practice Address - Street 2:
Practice Address - City:EAST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11730-1617
Practice Address - Country:US
Practice Address - Phone:631-277-8328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060974-11041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool