Provider Demographics
NPI:1760960090
Name:CARLINI, DAVID JON (LCSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JON
Last Name:CARLINI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3422 52ND ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-6322
Mailing Address - Country:US
Mailing Address - Phone:540-422-3344
Mailing Address - Fax:
Practice Address - Street 1:3422 52ND ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-6322
Practice Address - Country:US
Practice Address - Phone:540-422-3344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-30
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW153561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical