MEDICARE: CARMELLA R BARTIMOLE PH.D., LMHC

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	101YM0800X	Mental Health Counselor	003945-1	OK

General Provider Information

NPI Number	:	1508186339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMELLA R BARTIMOLE PH.D., LMHC

Provider Business Mailing Address
First Line	:	201 IRVING ST
Second Line	:
City	:	OLEAN
State	:	NY
Zip	:	14760-3521
Country	:	US
Telephone Number	:	716-307-6370
Fax Number	:	716-376-7022

Provider Business Practice Location Address
First Line	:	2626 W STATE ST
Second Line	:
City	:	OLEAN
State	:	NY
Zip	:	14760-1858
Country	:	US
Telephone Number	:	716-307-6370
Fax Number	:

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

Provider Enumeration Date	:	06/03/2010
Last Update Date	:	02/28/2024

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