Provider Demographics
NPI:1972101715
Name:KARWASHAN, NICOLE SOUSAN
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:SOUSAN
Last Name:KARWASHAN
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 1:30 CALVIN RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-3206
Mailing Address - Country:US
Mailing Address - Phone:401-919-1111
Mailing Address - Fax:
Practice Address - Street 1:297 KNOLLWOOD RD STE 304
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-1849
Practice Address - Country:US
Practice Address - Phone:401-919-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist