Provider Demographics
NPI:1669710968
Name:CAREY, JANIS MARILYN (LCSW)
Entity type:Individual
Prefix:
First Name:JANIS
Middle Name:MARILYN
Last Name:CAREY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JANIS
Other - Middle Name:MARILYN
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1101 TAMIAMI TRL S
Mailing Address - Street 2:SUITE 208
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-4133
Mailing Address - Country:US
Mailing Address - Phone:941-488-0124
Mailing Address - Fax:941-412-0477
Practice Address - Street 1:1101 TAMIAMI TRL S
Practice Address - Street 2:SUITE 208
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-4133
Practice Address - Country:US
Practice Address - Phone:941-488-0124
Practice Address - Fax:941-412-0477
Is Sole Proprietor?:No
Enumeration Date:2013-01-21
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW5262104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker