Provider Demographics
NPI:1205606381
Name:POMEROY, CARRIELI
Entity type:Individual
Prefix:MISS
First Name:CARRIELI
Middle Name:
Last Name:POMEROY
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 1:702 51ST ST E APT 1137B
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-5545
Mailing Address - Country:US
Mailing Address - Phone:859-443-0473
Mailing Address - Fax:
Practice Address - Street 1:9050 58TH DR E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202-6104
Practice Address - Country:US
Practice Address - Phone:941-907-0525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL182741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical