Provider Demographics
NPI:1558632430
Name:STANLEY, KAREN S (MSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:S
Last Name:STANLEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6804 PORTO FINO CIR STE 1
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-7139
Mailing Address - Country:US
Mailing Address - Phone:239-332-4700
Mailing Address - Fax:888-769-5641
Practice Address - Street 1:6804 PORTO FINO CIR STE 1
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-7139
Practice Address - Country:US
Practice Address - Phone:239-332-4700
Practice Address - Fax:888-769-5641
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical