Healthcare Provider Details

I. General information

NPI: 1679206247
Provider Name (Legal Business Name): KWANE OHENE BARTHLETT JR. MHTC, DMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2022
Last Update Date: 07/01/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2C-1 ESTATE MANDAHL 6540
SAINT THOMAS VI
00802
US

IV. Provider business mailing address

PO BOX 12018
SAINT THOMAS VI
00801
US

V. Phone/Fax

Practice location:
  • Phone: 202-256-1530
  • Fax:
Mailing address:
  • Phone: 340-201-2459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: