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General NPI Number Information
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NPI Number | 1841710050
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Entity Type | Individual
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Provider Name | KIMBERLY BARTA MSW, LICSW
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Gender | Female
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Dates
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Enumeration Date | 06/20/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 535 HOSPITAL RD
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City | NEW RICHMOND
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State | WI
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Zip | 54017-1449
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Country | US
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Telephone | 715-243-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 3100 W LAKE ST STE 210
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City | MINNEAPOLIS
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State | MN
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Zip | 55416-4597
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Country | US
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Telephone | 612-925-6033
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Fax | 612-925-8496
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 8857
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License Number State | WI
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