Provider Demographics
NPI:1326367855
Name:KARVOUNIS, TRICIA (LICSW, LCSW)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:
Last Name:KARVOUNIS
Suffix:
Gender:F
Credentials:LICSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8570 GRANITE CT STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-4240
Mailing Address - Country:US
Mailing Address - Phone:239-310-4646
Mailing Address - Fax:239-256-7516
Practice Address - Street 1:8570 GRANITE CT STE 101
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4240
Practice Address - Country:US
Practice Address - Phone:239-310-4646
Practice Address - Fax:239-256-7516
Is Sole Proprietor?:No
Enumeration Date:2010-05-24
Last Update Date:2021-07-30
Deactivation Date:2012-11-27
Deactivation Code:
Reactivation Date:2014-04-23
Provider Licenses
StateLicense IDTaxonomies
MA1152141041C0700X
MELC134221041C0700X
FL175751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical