Individual provider Active NPI

Karen Lee Brasile, LCSW

  • Clinical Social Worker
  • Fort Myers, FL
National Provider Identifier
1184900045
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW10521 Issued in FL
Practice address
12590 Whitehall Dr Ste 3
Fort Myers, FL 33907-4680
Phone
(239) 939-9090
NPI assigned
Oct 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW10521 FL Primary
Social Worker 104100000X #149.007381 IL

Addresses

Primary practice location

12590 Whitehall Dr Ste 3
Fort Myers, FL 33907-4680

Mailing address

972 Greenwood Court S
Sanibel, FL 33957
Phone (239) 395-4610

Other names 1

  • Miss Karen Lee Perkins Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120503000620 FL Practitioner - Clinical Social Worker 8527220771 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4310 Metro Pkwy
Suite 205
Fort Myers, FL 33916-9416
Phone (239) 223-2751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
#149.007381ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dna Comprehensive Therapy Services, LLC Clinical CurrentSince Sep 2, 2024 Accepting new patients
Bonita Springs Retirement Village, Inc. CurrentSince Sep 2, 2024 Accepting new patients
Ivan L Mazzorana Jr MD PA CurrentSince May 21, 2012 Accepting new patients

Locations

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

12590 Whitehall Dr
Ste 3
Fort Myers, FL 33907
Phone (239) 936-9338

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

Interoperability endpoints

  • Direct secure messaging: karen.brasile.1@13142.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1319414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1184900045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 GREENWOOD COURT S",
            "city": "SANIBEL",
            "state": "FL",
            "postal_code": "33957",
            "telephone_number": "239-395-4610",
            "fax_number": "239-395-4610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12590 WHITEHALL DR STE 3",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339074680",
            "telephone_number": "239-939-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASILE",
        "first_name": "KAREN",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-24",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10521",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "#149.007381",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "PERKINS",
            "middle_name": "LEE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.