MEDICARE: KATHY BARTON LLC

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	251S00000X	Community/Behavioral Health Agency	6801018276	MI

General Provider Information

NPI Number	:	1760641443
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATHY BARTON LLC

Provider Business Mailing Address
First Line	:	8111 NEW BRADFORD BLVD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48312-1107
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 MILVERTON DR
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48083-2528
Country	:	US
Telephone Number	:	586-419-2377
Fax Number	:	248-689-4325

Authorized Official
Title or Position	:	SOLE PROPRIETOR
Name	:	MRS. KATHY ANN BARTON
Credential	:	LMSW
Telephone Number	:	586-268-8165

Provider Enumeration Date	:	06/06/2008
Last Update Date	:	06/06/2008

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