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NPI Code Detail

MEDICARE: ANNALISE BARTOL LLMSW, CADC

MEDICARE: ANNALISE BARTOL LLMSW, CADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorMI
21041C0700XClinical Social Worker6801122366MI

General Provider Information

NPI Number : 1134648272
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNALISE BARTOL LLMSW, CADC
Provider Business Mailing Address
First Line : 1025 W WASHINGTON ST STE B
Second Line :
City : MARQUETTE
State : MI
Zip : 49855-4031
Country : US
Telephone Number : 906-256-2951
Fax Number :
Provider Business Practice Location Address
First Line : 1025 W WASHINGTON ST STE B
Second Line :
City : MARQUETTE
State : MI
Zip : 49855-4031
Country : US
Telephone Number : 906-256-2951
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2017
Last Update Date : 06/15/2026

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Directions to “ ANNALISE BARTOL LLMSW, CADC” Practice Location

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