Provider Demographics
NPI:1184900045
Name:BRASILE, KAREN LEE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LEE
Last Name:BRASILE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:LEE
Other - Last Name:PERKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:972 GREENWOOD COURT S
Mailing Address - Street 2:
Mailing Address - City:SANIBEL
Mailing Address - State:FL
Mailing Address - Zip Code:33957
Mailing Address - Country:US
Mailing Address - Phone:239-395-4610
Mailing Address - Fax:239-395-4610
Practice Address - Street 1:12590 WHITEHALL DR STE 3
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-4680
Practice Address - Country:US
Practice Address - Phone:239-939-9090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW105211041C0700X
IL#149.007381104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker