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1316658446 NPI number — KELLYN LACEY BARTON LSW, CSW

NPI Number: 1316658446
Health Care Provider/Practitioner: KELLYN LACEY BARTON LSW, CSW

Information about “1316658446” NPI (KELLYN LACEY BARTON LSW, CSW) exists in 1316658446 in HTML format HTML  |  1316658446 in plain Text format TXT  |  1316658446 in PDF (Portable Document Format) PDF  |  1316658446 in an XML format XML  formats.

NPI Number : 1316658446 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1316658446",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BARTON",
    "FirstName": "KELLYN",
    "MiddleName": "LACEY",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "LSW, CSW",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5549 W BLUEVAIL CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WEST JORDAN",
    "MailingAddressStateName": "UT",
    "MailingAddressPostalCode": "84081-5226",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "717-798-7117",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "563 W 500 S STE 220",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BOUNTIFUL",
    "PracticeLocationAddressStateName": "UT",
    "PracticeLocationAddressPostalCode": "84010-8289",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "717-790-1700",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/09/2022",
    "LastUpdateDate": "05/21/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "13683024-3502",
          "LicenseNumberStateCode": "UT",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "1041C0700X",
          "TaxonomyName": "Clinical Social Worker",
          "LicenseNumber": "SW139307",
          "LicenseNumberStateCode": "PA",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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