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NPI Code Detail

MEDICARE: GREGORY BARTELL LPC

MEDICARE: GREGORY BARTELL 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
1101YM0800XMental Health Counselor4914-125WI
2101YP2500XProfessional Counselor4914-125WI

General Provider Information

NPI Number : 1578862611
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY BARTELL LPC
Provider Business Mailing Address
First Line : 1701 DOUSMAN ST
Second Line :
City : GREEN BAY
State : WI
Zip : 54303-3211
Country : US
Telephone Number : 920-562-5617
Fax Number :
Provider Business Practice Location Address
First Line : 1701 DOUSMAN ST
Second Line :
City : GREEN BAY
State : WI
Zip : 54303-3211
Country : US
Telephone Number : 920-498-8600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2011
Last Update Date : 12/16/2025

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