Provider Demographics
NPI:1841620267
Name:DIAS, CAROLE JOY (LMFT)
Entity type:Individual
Prefix:DR
First Name:CAROLE
Middle Name:JOY
Last Name:DIAS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 NW 128TH RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-4003
Mailing Address - Country:US
Mailing Address - Phone:352-371-4648
Mailing Address - Fax:
Practice Address - Street 1:1810 NW 6TH ST STE C
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-8535
Practice Address - Country:US
Practice Address - Phone:386-853-0738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-21
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1905106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist