MEDICARE: AMY BARTON M. ED LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor
2	101Y00000X	Counselor	73881	TX

General Provider Information

NPI Number	:	1093247124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY BARTON M. ED LPC

Provider Business Mailing Address
First Line	:	717 W MAIN ST
Second Line	:
City	:	MIDLOTHIAN
State	:	TX
Zip	:	76065-2939
Country	:	US
Telephone Number	:	469-901-8550
Fax Number	:	972-723-5777

Provider Business Practice Location Address
First Line	:	717 W MAIN ST
Second Line	:
City	:	MIDLOTHIAN
State	:	TX
Zip	:	76065-2939
Country	:	US
Telephone Number	:	469-901-8550
Fax Number	:	972-723-5777

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2017
Last Update Date	:	06/08/2022

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