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General NPI Number Information
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NPI Number | 1316488067
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Entity Type | Organization
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Legal Business Name | W. MACK BARTELS, PSY.D. AND ASSOCIATES
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Dates
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Enumeration Date | 03/14/2017
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Last Update Date | 03/14/2017
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Provider Practice Location Address
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Address Line | 144 ROUTE 17M
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City | HARRIMAN
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State | NY
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Zip | 10926-3329
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Country | US
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Telephone | 845-395-0066
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Fax | 888-894-4861
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Provider Business Mailing Address
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Address Line | 144 ROUTE 17M
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City | HARRIMAN
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State | NY
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Zip | 10926-3329
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Country | US
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Telephone | 845-395-0066
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Fax | 888-894-4861
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. WILLIAM BARTELS
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Credential | PSY.D.
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Telephone | 914-805-3094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 043475
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 022780-R
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 016948-1
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License Number State | NY
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