Provider Demographics
NPI:1669262747
Name:GOTTLIEB, CARYN (LMHC)
Entity type:Individual
Prefix:
First Name:CARYN
Middle Name:
Last Name:GOTTLIEB
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9523 NEW POND RD # 16-101
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-5955
Mailing Address - Country:US
Mailing Address - Phone:469-263-8866
Mailing Address - Fax:
Practice Address - Street 1:9523 NEW POND RD # 16-101
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-5955
Practice Address - Country:US
Practice Address - Phone:469-263-8866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH25537101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health