Basic Information
Provider Information
NPI: 1528585767
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAPAGIKOS
FirstName: KARI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
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OtherLastName:  
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OtherCredential:  
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Mailing Information
Address1: 5329 HOLT RD
Address2:  
City: WILMINGTON
State: NC
PostalCode: 284092961
CountryCode: US
TelephoneNumber: 9106220814
FaxNumber:  
Practice Location
Address1: 120 COASTAL HORIZONS DR
Address2:  
City: SHALLOTTE
State: NC
PostalCode: 284706094
CountryCode: US
TelephoneNumber: 9107544515
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/28/2017
LastUpdateDate: 08/28/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XP011968NCY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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