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General NPI Number Information
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NPI Number | 1104991223
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Entity Type | Individual
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Provider Name | CLINTON E BARTLETT LPC
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Gender | Male
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 4300 N MILLER RD., SUITE E-116-07
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City | SCOTTSDALE
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State | AZ
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Zip | 85251
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Country | US
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Telephone | 602-751-7414
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Fax |
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Provider Business Mailing Address
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Address Line | 2124 E OASIS ST
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City | MESA
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State | AZ
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Zip | 85213-9742
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Country | US
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Telephone | 602-751-7414
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Fax | 602-926-2335
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC-10644
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License Number State | AZ
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