Provider Demographics
NPI:1376057158
Name:VARONA, KARLA
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:VARONA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HOOD PARK DR APT 331
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-1064
Mailing Address - Country:US
Mailing Address - Phone:646-470-1408
Mailing Address - Fax:
Practice Address - Street 1:2080 FREDERICK DOUGLASS BLVD APT 10A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10026-3486
Practice Address - Country:US
Practice Address - Phone:315-727-1551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-01
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010973-01101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health